| Lincoln Medical Center, Pc | |
|
5106 N Lincoln Ave Chicago IL 60625-3113 | |
| (773) 907-8255 | |
| (773) 907-8296 |
| Full Name | Lincoln Medical Center, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5106 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | Kijana Seferovic (PRESIDENT) |
| Authorized Official Contact | 7739078255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincoln Medical Center, Pc 5106 N Lincoln Ave Chicago IL 60625-3113 Ph: (773) 907-8255 | Lincoln Medical Center, Pc 5106 N Lincoln Ave Chicago IL 60625-3113 Ph: (773) 907-8255 |
| NPI Number | 1396916151 |
|---|---|
| Provider Enumeration Date | 03/19/2008 |
| Last Update Date | 02/02/2016 |
| Medicare PECOS PAC ID | 8527134584 |
|---|---|
| Medicare Enrollment ID | O20080828000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396916151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036113528 (Illinois) | Primary |
| Provider Name | Kijana Seferovic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821038274 PECOS PAC ID: 1557396041 Enrollment ID: I20051004000400 |
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