| La Sagrada Familia Medical Clinic Llc | |
|
6013 W Cermak Rd Cicero IL 60804-2018 | |
| (708) 222-9193 | |
| (708) 222-9198 |
| Full Name | La Sagrada Familia Medical Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6013 W Cermak Rd, Cicero, Illinois |
| Authorized Official Name and Position | Francisco Avalos (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7082229193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Sagrada Familia Medical Clinic Llc 6013 W Cermak Rd Cicero IL 60804-2018 Ph: (708) 222-9193 | La Sagrada Familia Medical Clinic Llc 6013 W Cermak Rd Cicero IL 60804-2018 Ph: (708) 222-9193 |
| NPI Number | 1164749594 |
|---|---|
| Provider Enumeration Date | 04/25/2010 |
| Last Update Date | 12/04/2010 |
| Medicare PECOS PAC ID | 1355536871 |
|---|---|
| Medicare Enrollment ID | O20101110000712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164749594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036-114621 (Illinois) | Primary |
| Provider Name | Francisco Avalos |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1245413574 PECOS PAC ID: 8123213659 Enrollment ID: I20101110000793 |
Roselia Herrera Md Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6039 W Cermak Rd, Cicero, IL 60804 Phone: 708-652-0056 | |
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