| Lincona Medical Associates, Ltd. | |
|
5131 N Lincoln Ave Chicago IL 60625-2585 | |
| (773) 878-1515 | |
| Not Available |
| Full Name | Lincona Medical Associates, Ltd. |
|---|---|
| Speciality | General Practice |
| Location | 5131 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | Laurence Hogstrom (INTERNAL MEDICINE) |
| Authorized Official Contact | 7738781515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincona Medical Associates, Ltd. 5131 N Lincoln Ave Chicago IL 60625-2585 Ph: (773) 878-1515 | Lincona Medical Associates, Ltd. 5131 N Lincoln Ave Chicago IL 60625-2585 Ph: (773) 878-1515 |
| NPI Number | 1124212576 |
|---|---|
| Provider Enumeration Date | 08/29/2007 |
| Last Update Date | 08/29/2007 |
| Medicare PECOS PAC ID | 9335187988 |
|---|---|
| Medicare Enrollment ID | O20050422001067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124212576 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Secondary |
| 207R00000X | Internal Medicine | (Illinois) | Secondary |
| 208D00000X | General Practice | (Illinois) | Primary |
| Provider Name | Laurence Hogstrom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659552800 PECOS PAC ID: 4082652649 Enrollment ID: I20101214000081 |
| Provider Name | Galina Gribovich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386825537 PECOS PAC ID: 9537107198 Enrollment ID: I20101214000143 |
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