| Lawndale Christian Health Center | |
|
3860 W Ogden Ave Chicago IL 60623-2460 | |
| (773) 843-2705 | |
| (773) 843-2704 |
| Full Name | Lawndale Christian Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3860 W Ogden Ave, Chicago, Illinois |
| Authorized Official Name and Position | Karen Johnson (ASST DIR OF PATIENT ACCOUNTING) |
| Authorized Official Contact | 8725883062 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lawndale Christian Health Center 3860 W Ogden Ave Chicago IL 60623-2460 Ph: () - | Lawndale Christian Health Center 3860 W Ogden Ave Chicago IL 60623-2460 Ph: (773) 843-2705 |
| NPI Number | 1245289214 |
|---|---|
| Provider Enumeration Date | 05/08/2006 |
| Last Update Date | 06/24/2021 |
| Medicare PECOS PAC ID | 2264336346 |
|---|---|
| Medicare Enrollment ID | O20031120000728 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245289214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Kara W. Greeley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013954296 PECOS PAC ID: 1052215027 Enrollment ID: I20031121000173 |
| Provider Name | Gabrielle W Barber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770520959 PECOS PAC ID: 6507854239 Enrollment ID: I20040503000946 |
| Provider Name | Barbara E Haas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184679540 PECOS PAC ID: 7810987526 Enrollment ID: I20040514000738 |
| Provider Name | Dae T Kwak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598710253 PECOS PAC ID: 1456321926 Enrollment ID: I20040730000640 |
| Provider Name | Hassan F Naom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255388542 PECOS PAC ID: 3274506670 Enrollment ID: I20040813001223 |
| Provider Name | Susanna C Chang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497792675 PECOS PAC ID: 1951354448 Enrollment ID: I20050224000444 |
| Provider Name | David Chang |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013907062 PECOS PAC ID: 9133025521 Enrollment ID: I20050725000624 |
| Provider Name | David R Miller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023055704 PECOS PAC ID: 2365472727 Enrollment ID: I20050816000239 |
| Provider Name | Jeannie L Wang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548253032 PECOS PAC ID: 2264463934 Enrollment ID: I20050823000815 |
| Provider Name | Tara A Dejesus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477590651 PECOS PAC ID: 3678589702 Enrollment ID: I20060228000155 |
| Provider Name | Mary Ellen Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497836134 PECOS PAC ID: 3274543426 Enrollment ID: I20060502000642 |
| Provider Name | Rodrigue Meyou Tinfang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033290481 PECOS PAC ID: 3870591753 Enrollment ID: I20061201000460 |
| Provider Name | Ravikiran A Barigala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801805437 PECOS PAC ID: 7911908314 Enrollment ID: I20070129000177 |
| Provider Name | Keith So |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437218682 PECOS PAC ID: 0042212938 Enrollment ID: I20070206000294 |
| Provider Name | Daisey D Dowell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710996301 PECOS PAC ID: 7315049699 Enrollment ID: I20070219000027 |
| Provider Name | Brian M Fagan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831280494 PECOS PAC ID: 3274635487 Enrollment ID: I20070219000343 |
| Provider Name | Sally S Canning |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992886535 PECOS PAC ID: 7517067663 Enrollment ID: I20070703000311 |
| Provider Name | Ann S Mclaughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063448413 PECOS PAC ID: 5597865907 Enrollment ID: I20070714000130 |
| Provider Name | Heidi J Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013946441 PECOS PAC ID: 5294826541 Enrollment ID: I20070801000367 |
| Provider Name | Thomas D Huggett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174517411 PECOS PAC ID: 7315035227 Enrollment ID: I20071109000556 |
| Provider Name | Christine A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740379676 PECOS PAC ID: 4082702113 Enrollment ID: I20071126000598 |
| Provider Name | James B Melia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164477535 PECOS PAC ID: 2365513876 Enrollment ID: I20080611000122 |
| Provider Name | Mary M Westerholm |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790951093 PECOS PAC ID: 4880752609 Enrollment ID: I20081023000375 |
| Provider Name | Basal I Al Aswad |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033104641 PECOS PAC ID: 6800951880 Enrollment ID: I20090209000480 |
| Provider Name | Michael L Kijowski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669415584 PECOS PAC ID: 3870659790 Enrollment ID: I20090302000343 |
| Provider Name | Catherine T Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659532877 PECOS PAC ID: 4981760493 Enrollment ID: I20090309000474 |
| Provider Name | Bolanle O Soyannwo Balogun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316122468 PECOS PAC ID: 6103973557 Enrollment ID: I20090422000167 |
| Provider Name | Donna J Nielsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821007345 PECOS PAC ID: 5092864116 Enrollment ID: I20090520000506 |
| Provider Name | Karla Torres |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760674683 PECOS PAC ID: 1759436835 Enrollment ID: I20090826000618 |
| Provider Name | Amy Jo Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568623197 PECOS PAC ID: 7315084803 Enrollment ID: I20091103000204 |
| Provider Name | Susan J Anderson Nelson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1013904986 PECOS PAC ID: 2365425451 Enrollment ID: I20100206000149 |
| Provider Name | Adam Henry Romeiser |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558527044 PECOS PAC ID: 2365576055 Enrollment ID: I20100817000830 |
| Provider Name | Sandra L Hoogland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578518320 PECOS PAC ID: 5698960359 Enrollment ID: I20101109000033 |
| Provider Name | John M Katana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215194733 PECOS PAC ID: 3375732175 Enrollment ID: I20110110000624 |
| Provider Name | Robert T Stannard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730173071 PECOS PAC ID: 7911189691 Enrollment ID: I20110317000132 |
| Provider Name | David A Buchanan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689611865 PECOS PAC ID: 5496659583 Enrollment ID: I20110526000266 |
| Provider Name | Wayne M Detmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972558880 PECOS PAC ID: 2567649759 Enrollment ID: I20110616000298 |
| Provider Name | Julia F Romeiser |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538325071 PECOS PAC ID: 0648442863 Enrollment ID: I20111012000792 |
| Provider Name | Christopher M Flinn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063668341 PECOS PAC ID: 1658544853 Enrollment ID: I20111103000711 |
| Provider Name | Sabrina M Reed |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235260043 PECOS PAC ID: 6002908340 Enrollment ID: I20120315000505 |
| Provider Name | Theodore T Park |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194947648 PECOS PAC ID: 9436343803 Enrollment ID: I20130325000479 |
| Provider Name | Margaret C Johnson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992055487 PECOS PAC ID: 0648416792 Enrollment ID: I20130417000121 |
| Provider Name | Nellie Esther Lovelace Fleming |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003835364 PECOS PAC ID: 2466559620 Enrollment ID: I20130529000282 |
| Provider Name | Rosario M Cosme Cruz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811298987 PECOS PAC ID: 6103060579 Enrollment ID: I20130925000404 |
| Provider Name | Janice F Huber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649474404 PECOS PAC ID: 6901991819 Enrollment ID: I20131111000101 |
| Provider Name | Stephen C Chiu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629362223 PECOS PAC ID: 8325274947 Enrollment ID: I20131203001828 |
| Provider Name | Lydia C Colin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134559784 PECOS PAC ID: 0143443093 Enrollment ID: I20140521001096 |
| Provider Name | Jennifer Lin Herther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265868624 PECOS PAC ID: 3072736818 Enrollment ID: I20140522001656 |
| Provider Name | Adam H Romeiser |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386768836 PECOS PAC ID: 3779706569 Enrollment ID: I20140523001233 |
| Provider Name | Erin E Mann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588086029 PECOS PAC ID: 4183847916 Enrollment ID: I20140527000051 |
| Provider Name | Lakieta Edwards Glass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053739813 PECOS PAC ID: 7719100304 Enrollment ID: I20140529001481 |
| Provider Name | Andrew Sapthavee |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1972746766 PECOS PAC ID: 9234355405 Enrollment ID: I20140723002626 |
| Provider Name | Jane M Trimberger |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851706121 PECOS PAC ID: 3971720459 Enrollment ID: I20140806001526 |
| Provider Name | Mary E Hegstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841586799 PECOS PAC ID: 8426278599 Enrollment ID: I20141014000009 |
| Provider Name | Megan Song |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023302510 PECOS PAC ID: 6800017898 Enrollment ID: I20141015002218 |
| Provider Name | Jeffrey Larson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144516097 PECOS PAC ID: 2668694837 Enrollment ID: I20141104001786 |
| Provider Name | Grace G Larson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1609279819 PECOS PAC ID: 4587886973 Enrollment ID: I20141120000332 |
| Provider Name | Susan J Erlenborn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265524656 PECOS PAC ID: 0547482861 Enrollment ID: I20141120001459 |
| Provider Name | Helen T Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427214931 PECOS PAC ID: 5597916411 Enrollment ID: I20141210000500 |
| Provider Name | Kathryn Mclean |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023411329 PECOS PAC ID: 2961725361 Enrollment ID: I20141215002531 |
| Provider Name | Maureen M Powers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619179934 PECOS PAC ID: 9335462308 Enrollment ID: I20141223001529 |
| Provider Name | Helen Tewelde |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760626204 PECOS PAC ID: 4385968692 Enrollment ID: I20150114002487 |
| Provider Name | Kathryn Michelle Lee Noll |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982991774 PECOS PAC ID: 2860717857 Enrollment ID: I20150216000546 |
| Provider Name | Brittany L Mehta |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1245628593 PECOS PAC ID: 3476870866 Enrollment ID: I20150324000566 |
| Provider Name | Casey E Clardy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689907834 PECOS PAC ID: 3870812316 Enrollment ID: I20150505000004 |
| Provider Name | Gail I Van Wingerden Dons |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598767741 PECOS PAC ID: 9335311893 Enrollment ID: I20150505000011 |
| Provider Name | Heather L Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386047769 PECOS PAC ID: 2860711306 Enrollment ID: I20150505000031 |
| Provider Name | Patricia Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750536223 PECOS PAC ID: 1557596038 Enrollment ID: I20150602000262 |
| Provider Name | Doran M Duke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053671479 PECOS PAC ID: 3375856537 Enrollment ID: I20150716001610 |
| Provider Name | Elizabeth A Redican |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154615797 PECOS PAC ID: 4183854987 Enrollment ID: I20150917002303 |
| Provider Name | Caitlin M Dahmer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1427434596 PECOS PAC ID: 3870803489 Enrollment ID: I20151111001973 |
| Provider Name | Eugenia T Sanders |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801833595 PECOS PAC ID: 9335459767 Enrollment ID: I20151113001692 |
| Provider Name | Gina Detmer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295772473 PECOS PAC ID: 8426358904 Enrollment ID: I20151207000813 |
| Provider Name | Leslie M Waddell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386963528 PECOS PAC ID: 3678874732 Enrollment ID: I20151214001844 |
| Provider Name | Patricia K Kinsey |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215307277 PECOS PAC ID: 3577865781 Enrollment ID: I20160105002099 |
| Provider Name | Theresa A Kijowski |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1083669774 PECOS PAC ID: 9931424165 Enrollment ID: I20160106000023 |
| Provider Name | Benjamin A Preyss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285997650 PECOS PAC ID: 8820392145 Enrollment ID: I20160208000820 |
| Provider Name | Julie J Pak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255793162 PECOS PAC ID: 7113224502 Enrollment ID: I20160330001213 |
| Provider Name | Bruce W Rowell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225085467 PECOS PAC ID: 2668766882 Enrollment ID: I20160811001006 |
| Provider Name | Jessica Lue-lai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538478565 PECOS PAC ID: 2466694005 Enrollment ID: I20160831001555 |
| Provider Name | Emely R De La O |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205285913 PECOS PAC ID: 0749576726 Enrollment ID: I20160831002172 |
| Provider Name | James Hwang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134489446 PECOS PAC ID: 7911120662 Enrollment ID: I20160913000837 |
| Provider Name | Hannah Jacobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881057479 PECOS PAC ID: 8325335888 Enrollment ID: I20160927001426 |
| Provider Name | Michael A Sethi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679917868 PECOS PAC ID: 0345481842 Enrollment ID: I20161025000552 |
| Provider Name | Kristen L Drake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184091670 PECOS PAC ID: 0143508291 Enrollment ID: I20161025001942 |
| Provider Name | Ryan Geoffrey Fabrizius |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851683122 PECOS PAC ID: 2264679992 Enrollment ID: I20161025002719 |
| Provider Name | Peter A Kuhl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548377542 PECOS PAC ID: 3072529825 Enrollment ID: I20161025002979 |
| Provider Name | Truly Gannon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1275857138 PECOS PAC ID: 4587943394 Enrollment ID: I20161118001709 |
| Provider Name | Pui-wing W Dy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811151236 PECOS PAC ID: 3971884404 Enrollment ID: I20161221001361 |
| Provider Name | John Tannous |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164775912 PECOS PAC ID: 3971876202 Enrollment ID: I20170907001474 |
| Provider Name | Juliana Lee |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1821472275 PECOS PAC ID: 9436422771 Enrollment ID: I20170907001901 |
| Provider Name | Peter Girgis |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1700235116 PECOS PAC ID: 0840587143 Enrollment ID: I20170907002162 |
| Provider Name | Melissa Preyss |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073952768 PECOS PAC ID: 1153624945 Enrollment ID: I20170912001459 |
| Provider Name | Eleanore Whelan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275037319 PECOS PAC ID: 3476818956 Enrollment ID: I20180604002568 |
| Provider Name | Elisa Marie Crystal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942615646 PECOS PAC ID: 3072860030 Enrollment ID: I20180720003010 |
| Provider Name | John C Houchins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740211911 PECOS PAC ID: 6507830452 Enrollment ID: I20180724002623 |
| Provider Name | Micah Grace Hong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285014829 PECOS PAC ID: 3779888284 Enrollment ID: I20180807003850 |
| Provider Name | Jenny J Wang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356845358 PECOS PAC ID: 2365792843 Enrollment ID: I20180904001582 |
| Provider Name | Katherine Matics |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841779733 PECOS PAC ID: 9335499342 Enrollment ID: I20180912000339 |
| Provider Name | Jayme Stine |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699161448 PECOS PAC ID: 6204187123 Enrollment ID: I20180915000120 |
| Provider Name | Stephanie Nicole Solari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871088591 PECOS PAC ID: 7113278755 Enrollment ID: I20180920003483 |
| Provider Name | Shaun Huang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780151936 PECOS PAC ID: 4587908769 Enrollment ID: I20181128002079 |
| Provider Name | Brendan Lawrence Webb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740371186 PECOS PAC ID: 5294628707 Enrollment ID: I20190227002865 |
| Provider Name | Louisa Olushoga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386025088 PECOS PAC ID: 2163726829 Enrollment ID: I20190806001349 |
| Provider Name | Suyeun Ban |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003269846 PECOS PAC ID: 8426481300 Enrollment ID: I20191206001503 |
| Provider Name | Allison Thoburn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962881086 PECOS PAC ID: 7618289117 Enrollment ID: I20191219002188 |
| Provider Name | Shelly Navato Capps |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043667371 PECOS PAC ID: 6002186707 Enrollment ID: I20200205002326 |
| Provider Name | Tiffany D Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982050985 PECOS PAC ID: 7113211558 Enrollment ID: I20200218001190 |
| Provider Name | Thomas Courville Yates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861920779 PECOS PAC ID: 4981974136 Enrollment ID: I20210224001071 |
| Provider Name | Kaela Yates |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417481086 PECOS PAC ID: 9638441041 Enrollment ID: I20210318000020 |
| Provider Name | Matthew Hussey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396386850 PECOS PAC ID: 6507273521 Enrollment ID: I20210318001056 |
| Provider Name | Gloria Cecilia Valiente |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447311089 PECOS PAC ID: 1153738190 Enrollment ID: I20210318001880 |
| Provider Name | Liesel Ratliff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134755390 PECOS PAC ID: 8820405707 Enrollment ID: I20210319000988 |
| Provider Name | Alexander J Porte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205285301 PECOS PAC ID: 8628360575 Enrollment ID: I20210319001393 |
| Provider Name | Ambria Anderson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1033722517 PECOS PAC ID: 8628485521 Enrollment ID: I20210319001535 |
| Provider Name | Ashley Mallory |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730542077 PECOS PAC ID: 1658669296 Enrollment ID: I20210322002095 |
| Provider Name | Nora Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396391926 PECOS PAC ID: 4880001619 Enrollment ID: I20210323002695 |
| Provider Name | Naomi N Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194106849 PECOS PAC ID: 7810201928 Enrollment ID: I20210329001774 |
| Provider Name | Heather Bilyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013562867 PECOS PAC ID: 4688083389 Enrollment ID: I20210510002434 |
| Provider Name | Kayla Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649855511 PECOS PAC ID: 7315342946 Enrollment ID: I20210819003842 |
| Provider Name | Michelle J Yoo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265929608 PECOS PAC ID: 0345596441 Enrollment ID: I20210927001773 |
| Provider Name | Jenna Genre |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1487329439 PECOS PAC ID: 5890192215 Enrollment ID: I20210927002541 |
| Provider Name | Elizabeth L Lockerman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952806580 PECOS PAC ID: 0749538767 Enrollment ID: I20211022000343 |
| Provider Name | Teneshia Auston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265100705 PECOS PAC ID: 8426446352 Enrollment ID: I20211026003499 |
| Provider Name | Christine Garces |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689341174 PECOS PAC ID: 3476942822 Enrollment ID: I20211105001265 |
| Provider Name | Michael Kim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023609005 PECOS PAC ID: 3274926225 Enrollment ID: I20220215001723 |
| Provider Name | Reanne Lappinga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851047013 PECOS PAC ID: 7315322153 Enrollment ID: I20220915001187 |
| Provider Name | Benjamin German |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740716281 PECOS PAC ID: 5698001576 Enrollment ID: I20220920001428 |
| Provider Name | Jarrett Yu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073213807 PECOS PAC ID: 0446619761 Enrollment ID: I20230705002812 |
| Provider Name | Nicole Gim-foong Chin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326662974 PECOS PAC ID: 8224424940 Enrollment ID: I20230921000903 |
| Provider Name | Audrieanna Marie Kramer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235759069 PECOS PAC ID: 2466873757 Enrollment ID: I20231005003054 |
| Provider Name | Erick Woodrow Skaff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568920171 PECOS PAC ID: 1951756865 Enrollment ID: I20231012003032 |
| Provider Name | Florence Hsiao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043771934 PECOS PAC ID: 7214337278 Enrollment ID: I20231023000268 |
| Provider Name | Joongyu Song |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003376062 PECOS PAC ID: 3476888694 Enrollment ID: I20231023000892 |
| Provider Name | Monica Naumann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124290424 PECOS PAC ID: 6800037680 Enrollment ID: I20240606000540 |
Pilsen Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1952 W Cermak Rd, Chicago, IL 60608 Phone: 773-254-6611 Fax: 773-254-8590 | |
A Kavaliunas Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5540 S Pulaski Rd, Chicago, IL 60629 Phone: 773-585-2802 | |
Doc Cam Medical Center Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2315 E 93rd St Ste 337, Chicago, IL 60617 Phone: 773-731-2700 Fax: 773-373-1868 | |
Excellent Eye Care Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5352 N Milwaukee Ave, Chicago, IL 60630 Phone: 773-777-7444 Fax: 773-775-4030 | |
Pediatric General Care & Research Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4527 N Pulaski Rd, Chicago, IL 60630 Phone: 773-267-7060 Fax: 773-267-4752 | |
Urban Family Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10830 S Halsted St, Chicago, IL 60628 Phone: 773-264-1400 Fax: 773-264-1401 | |
Premier Primary Care And Alternative Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1301 E 47th Street, Bldg 2 Suite B, Chicago, IL 60653 Phone: 773-891-2890 Fax: 773-891-4107 |