Lake County Internal Medicine Associates, Llc | |
5911 Kildeer Ct Long Grove IL 60047-5052 | |
(847) 478-5108 | |
Not Available |
Full Name | Lake County Internal Medicine Associates, Llc |
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Speciality | Internal Medicine |
Location | 5911 Kildeer Ct, Long Grove, Illinois |
Authorized Official Name and Position | Mariusz Milejczyk (PRESIDENT) |
Authorized Official Contact | 8474785108 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lake County Internal Medicine Associates, Llc 5911 Kildeer Ct Long Grove IL 60047-5052 Ph: () - | Lake County Internal Medicine Associates, Llc 5911 Kildeer Ct Long Grove IL 60047-5052 Ph: (847) 478-5108 |
NPI Number | 1154686525 |
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Provider Enumeration Date | 07/11/2012 |
Last Update Date | 07/11/2012 |
Medicare PECOS PAC ID | 7416103817 |
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Medicare Enrollment ID | O20120816000722 |
Identifier | Type | State | Issuer |
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1154686525 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Mariusz Milejczyk |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1467598235 PECOS PAC ID: 0840399788 Enrollment ID: I20070619000177 |
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