| Jfa Medical Group Sc | |
|
732 S Pulaski Rd Chicago IL 60624-4058 | |
| (773) 533-1621 | |
| Not Available |
| Full Name | Jfa Medical Group Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 732 S Pulaski Rd, Chicago, Illinois |
| Authorized Official Name and Position | Mohammed J Ali (OWNER) |
| Authorized Official Contact | 7735331621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jfa Medical Group Sc 211 Somerset Rd Willowbrook IL 60527-5430 Ph: (630) 455-5531 | Jfa Medical Group Sc 732 S Pulaski Rd Chicago IL 60624-4058 Ph: (773) 533-1621 |
| NPI Number | 1356664833 |
|---|---|
| Provider Enumeration Date | 03/11/2010 |
| Last Update Date | 03/11/2010 |
| Medicare PECOS PAC ID | 5799810446 |
|---|---|
| Medicare Enrollment ID | O20100319000139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356664833 | NPI | - | NPPES |
| 036062868 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036062868 (Illinois) | Primary |
| Provider Name | Mohammed J Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164552055 PECOS PAC ID: 2264567916 Enrollment ID: I20100319000125 |
| Provider Name | Rashda B Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609935816 PECOS PAC ID: 9436339157 Enrollment ID: I20110211000397 |
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