| Legacy Medical Care Inc | |
|
519 Dundee Ave East Dundee IL 60118-1642 | |
| (847) 749-2248 | |
| Not Available |
| Full Name | Legacy Medical Care Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 519 Dundee Ave, East Dundee, Illinois |
| Authorized Official Name and Position | Melissa Donorio (CEO) |
| Authorized Official Contact | 8477492248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Medical Care Inc 519 Dundee Ave East Dundee IL 60118-1642 Ph: () - | Legacy Medical Care Inc 519 Dundee Ave East Dundee IL 60118-1642 Ph: (847) 749-2248 |
| NPI Number | 1003365412 |
|---|---|
| Provider Enumeration Date | 09/26/2016 |
| Last Update Date | 09/26/2016 |
| Medicare PECOS PAC ID | 7416183298 |
|---|---|
| Medicare Enrollment ID | O20170724000423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003365412 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Illinois) | Primary |
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