Md At Home | |
2003 W Fulton St Ste 303 Chicago IL 60612-2345 | |
(312) 243-2223 | |
(312) 243-2227 |
Full Name | Md At Home |
---|---|
Speciality | Internal Medicine |
Location | 2003 W Fulton St Ste 303, Chicago, Illinois |
Authorized Official Name and Position | Sue Hall (DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 3122432223 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Md At Home 2003 W Fulton St Ste 303 Chicago IL 60612-2345 Ph: (312) 243-2223 | Md At Home 2003 W Fulton St Ste 303 Chicago IL 60612-2345 Ph: (312) 243-2223 |
NPI Number | 1568758415 |
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Provider Enumeration Date | 06/20/2011 |
Last Update Date | 12/28/2022 |
Medicare PECOS PAC ID | 7810167830 |
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Medicare Enrollment ID | O20110831000340 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568758415 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
207R00000X | Internal Medicine | (Illinois) | Secondary |
Provider Name | Michelle Alexandre |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1477604791 PECOS PAC ID: 0143115576 Enrollment ID: I20040216000973 |
Provider Name | Doris Shuwen Huang |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447304431 PECOS PAC ID: 4385627678 Enrollment ID: I20040609000043 |
Provider Name | Kimberly A Williams |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1790736601 PECOS PAC ID: 0749265999 Enrollment ID: I20040622000347 |
Provider Name | Mark D Weissman |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1366426538 PECOS PAC ID: 9133022890 Enrollment ID: I20040813000380 |
Provider Name | Brian S Boe |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1124049473 PECOS PAC ID: 9032155452 Enrollment ID: I20050707000137 |
Provider Name | Kristi Gallegos |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386730455 PECOS PAC ID: 6103825583 Enrollment ID: I20061212000587 |
Provider Name | Wakas N Ahmad |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1447446521 PECOS PAC ID: 1456449925 Enrollment ID: I20071116000156 |
Provider Name | Maria T Perez |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1285811166 PECOS PAC ID: 3375550874 Enrollment ID: I20081125000501 |
Provider Name | Mary Kay Larson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124293691 PECOS PAC ID: 2769534221 Enrollment ID: I20090714000296 |
Provider Name | Luan Seiko |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1346470465 PECOS PAC ID: 6406901735 Enrollment ID: I20090909000714 |
Provider Name | Stuart Peiss |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1427092055 PECOS PAC ID: 7416946959 Enrollment ID: I20100323000098 |
Provider Name | Qaiser Jamal |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1730129461 PECOS PAC ID: 8820261191 Enrollment ID: I20111101000715 |
Provider Name | Sandra Gonzales |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053691915 PECOS PAC ID: 0648432096 Enrollment ID: I20120501000106 |
Provider Name | Adaku Ngozika Madubuko |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1649569948 PECOS PAC ID: 1456513555 Enrollment ID: I20120508000168 |
Provider Name | Gianetta Norwood |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619250289 PECOS PAC ID: 7012173107 Enrollment ID: I20120717000603 |
Provider Name | Kelley O Holloway Marshall |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1942593231 PECOS PAC ID: 6608026166 Enrollment ID: I20121019000037 |
Provider Name | David P Lang |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1619167194 PECOS PAC ID: 7618129461 Enrollment ID: I20121130000586 |
Provider Name | Denise R Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346674579 PECOS PAC ID: 2163658626 Enrollment ID: I20131112001030 |
Provider Name | Elizabeth J Kelly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306281167 PECOS PAC ID: 4486881638 Enrollment ID: I20131213000099 |
Provider Name | Olga Geniyevna Kozlova |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1477997674 PECOS PAC ID: 5991924763 Enrollment ID: I20140910001963 |
Provider Name | Lisa Taylor |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174914246 PECOS PAC ID: 0446577142 Enrollment ID: I20150317001921 |
Provider Name | Janet M Thompson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891213963 PECOS PAC ID: 3870859184 Enrollment ID: I20171102000006 |
Provider Name | Nicolas Cordoba |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1700132628 PECOS PAC ID: 4486913696 Enrollment ID: I20180116001869 |
Provider Name | Hyunjung Shin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972009231 PECOS PAC ID: 6709140056 Enrollment ID: I20180514001805 |
Provider Name | Zain Hasan Rizvi |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1285021980 PECOS PAC ID: 9234486192 Enrollment ID: I20180724000591 |
Provider Name | Kate Erin Myczek |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235658287 PECOS PAC ID: 1153679857 Enrollment ID: I20180810002203 |
Provider Name | Zubair A Khan |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1780050195 PECOS PAC ID: 8022367556 Enrollment ID: I20180816002449 |
Provider Name | Francois Roger Belin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790277457 PECOS PAC ID: 8022361963 Enrollment ID: I20181023003022 |
Provider Name | Marie S Dorsey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770068454 PECOS PAC ID: 6204189707 Enrollment ID: I20181031000760 |
Provider Name | Ahmad Daif |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1326459553 PECOS PAC ID: 5890082317 Enrollment ID: I20181128000862 |
Provider Name | Catherine Chase |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366830275 PECOS PAC ID: 3072858513 Enrollment ID: I20190102002468 |
Provider Name | Lovely William George |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588138416 PECOS PAC ID: 4688913312 Enrollment ID: I20190225001918 |
Provider Name | Shannon Atsinger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164997870 PECOS PAC ID: 4486993151 Enrollment ID: I20190226000065 |
Provider Name | Sara A Hormig |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164826012 PECOS PAC ID: 2769706936 Enrollment ID: I20190305003281 |
Provider Name | Tawnie Cersie Caracci |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093287187 PECOS PAC ID: 0547509556 Enrollment ID: I20190308000071 |
Provider Name | Shay L Ward |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013472455 PECOS PAC ID: 7810238755 Enrollment ID: I20190403000567 |
Provider Name | Michelle Spleha |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861952160 PECOS PAC ID: 5092056713 Enrollment ID: I20190408000362 |
Provider Name | Lynn Kropp |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811496821 PECOS PAC ID: 0345582912 Enrollment ID: I20190501000011 |
Provider Name | Monica Lisa Bieszczad |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124513080 PECOS PAC ID: 4981947991 Enrollment ID: I20190515000170 |
Provider Name | Linda M Kolka |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013404151 PECOS PAC ID: 4082957006 Enrollment ID: I20190515000538 |
Provider Name | Sharon Hayes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881014793 PECOS PAC ID: 3274855069 Enrollment ID: I20190702003410 |
Provider Name | Tiraney C Redmond |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538639406 PECOS PAC ID: 8820324270 Enrollment ID: I20190724000338 |
Provider Name | Kanako Ishida |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881178366 PECOS PAC ID: 1456697879 Enrollment ID: I20190725003408 |
Provider Name | Shuying Chang |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376109918 PECOS PAC ID: 4486981214 Enrollment ID: I20190816000019 |
Provider Name | Tia J Hanke |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568014843 PECOS PAC ID: 6709117740 Enrollment ID: I20191007000836 |
Provider Name | Stephanie Baubie |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518508381 PECOS PAC ID: 5092047894 Enrollment ID: I20191029000062 |
Provider Name | Rena Chaya Schwartz |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1073154688 PECOS PAC ID: 5193057677 Enrollment ID: I20191102000148 |
Provider Name | Emily Anne Lawrence |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629545595 PECOS PAC ID: 0042642118 Enrollment ID: I20191111001252 |
Provider Name | Sylvia Coleman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1205471083 PECOS PAC ID: 4082047311 Enrollment ID: I20191127001179 |
Provider Name | Skaiste Tarnauskas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437796133 PECOS PAC ID: 6406280890 Enrollment ID: I20191217002711 |
Provider Name | Azeezat Omotoyosi Adeduntan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750927661 PECOS PAC ID: 8820422520 Enrollment ID: I20200106002948 |
Provider Name | Erica J Lopez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346880275 PECOS PAC ID: 5092140004 Enrollment ID: I20200122001470 |
Provider Name | Waseem Alfahel |
---|---|
Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1467959031 PECOS PAC ID: 0143551390 Enrollment ID: I20200127002046 |
Provider Name | Monique Nicole Kilian |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366082745 PECOS PAC ID: 8022445170 Enrollment ID: I20200302000970 |
Provider Name | Mahmoud M Okash |
---|---|
Provider Type | Practitioner - Thoracic Surgery |
Provider Identifiers | NPI Number: 1194129692 PECOS PAC ID: 6800224833 Enrollment ID: I20200325000842 |
Provider Name | Rickeda Granberry |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689293987 PECOS PAC ID: 6103257993 Enrollment ID: I20200511003408 |
Provider Name | Janelle Sabado Wong |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902423759 PECOS PAC ID: 5890113880 Enrollment ID: I20200908000996 |
Provider Name | Susan D Thompson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164771242 PECOS PAC ID: 3173778032 Enrollment ID: I20200929003684 |
Provider Name | Izolda Rosario |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083222368 PECOS PAC ID: 8820417181 Enrollment ID: I20201006001643 |
Provider Name | Veronica Gore |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902403298 PECOS PAC ID: 0547680829 Enrollment ID: I20201027000815 |
Provider Name | Mara D Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093312001 PECOS PAC ID: 0648681007 Enrollment ID: I20201117000154 |
Provider Name | Phyllis Eggleston |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043834435 PECOS PAC ID: 9133530009 Enrollment ID: I20201125000268 |
Provider Name | Nekeisha Lynn Sturghill |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922633379 PECOS PAC ID: 4981015674 Enrollment ID: I20201202000612 |
Provider Name | Julia Zelenik |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164073599 PECOS PAC ID: 4880006527 Enrollment ID: I20201222000530 |
Provider Name | Maria Fariduddin |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1336692573 PECOS PAC ID: 9234476805 Enrollment ID: I20210122001718 |
Provider Name | Jessica Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811032683 PECOS PAC ID: 5294140968 Enrollment ID: I20210211001196 |
Provider Name | Kimberly Lopez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477144020 PECOS PAC ID: 9931514007 Enrollment ID: I20210223001790 |
Provider Name | Yvonne Batton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912592940 PECOS PAC ID: 3375959711 Enrollment ID: I20210309001919 |
Provider Name | Maria Bitting |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134715733 PECOS PAC ID: 9638585714 Enrollment ID: I20210316000920 |
Provider Name | Theodise Harris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1134716830 PECOS PAC ID: 2961811997 Enrollment ID: I20210504001971 |
Provider Name | Ester Sigurdardottir |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1104492107 PECOS PAC ID: 3678973880 Enrollment ID: I20210609002918 |
Provider Name | Jory Zimmerman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760073530 PECOS PAC ID: 1254731193 Enrollment ID: I20210614002564 |
Provider Name | Hanna Vintonyak |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043886062 PECOS PAC ID: 6709286263 Enrollment ID: I20210621002523 |
Provider Name | Stephanie Atoyebi |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1548826571 PECOS PAC ID: 0547664575 Enrollment ID: I20210812000866 |
Provider Name | Olivia Korpus |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295323137 PECOS PAC ID: 3971911926 Enrollment ID: I20210812003475 |
Provider Name | Alexandra Nicole Lyewski |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457028177 PECOS PAC ID: 9436555950 Enrollment ID: I20210909000940 |
Provider Name | Shaheera Fatima Khan |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1861059834 PECOS PAC ID: 6002213360 Enrollment ID: I20210929001401 |
Provider Name | Calena Goins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700453198 PECOS PAC ID: 2567853781 Enrollment ID: I20211223001447 |
Provider Name | Alisha R Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649936485 PECOS PAC ID: 6507251121 Enrollment ID: I20220317002375 |
Provider Name | Phillip Ozell Carr |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538813936 PECOS PAC ID: 4688060072 Enrollment ID: I20220412001797 |
Provider Name | Davinder K Dhillon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780331033 PECOS PAC ID: 9830578152 Enrollment ID: I20220616001771 |
Provider Name | Jamie Lowe |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174271043 PECOS PAC ID: 3779964267 Enrollment ID: I20220714002426 |
Provider Name | Monik Vinod Patel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1346977121 PECOS PAC ID: 7416331491 Enrollment ID: I20220825002517 |
Provider Name | Christina Malek |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285367656 PECOS PAC ID: 3971988098 Enrollment ID: I20220909002127 |
Provider Name | Loredana Tatiana Deichl |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568047983 PECOS PAC ID: 0547637704 Enrollment ID: I20221101003242 |
Provider Name | Huijing Sun |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1548977606 PECOS PAC ID: 5698144756 Enrollment ID: I20221212001929 |
Provider Name | Baongoc Truong |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1275253866 PECOS PAC ID: 6800266586 Enrollment ID: I20221222000674 |
Provider Name | Suzanne Gabbidon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861104846 PECOS PAC ID: 2466822655 Enrollment ID: I20230104002021 |
Provider Name | Gajendra Maharjan |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1962078923 PECOS PAC ID: 4284007683 Enrollment ID: I20230306002544 |
Provider Name | Claudia Viviana Rodriguez |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1053024588 PECOS PAC ID: 5890169544 Enrollment ID: I20230320000740 |
Provider Name | Maria Sukhoo |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1619435245 PECOS PAC ID: 1850720616 Enrollment ID: I20230511003560 |
Provider Name | Nicole Rodiek |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144913500 PECOS PAC ID: 3971962044 Enrollment ID: I20230707000857 |
Provider Name | Verna K Guevarra |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942575188 PECOS PAC ID: 2567818008 Enrollment ID: I20231019002536 |
Provider Name | Vera Appiah-dankwah |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538944749 PECOS PAC ID: 6901252295 Enrollment ID: I20231023001949 |
Provider Name | Michael Mancano |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1649912692 PECOS PAC ID: 7810343068 Enrollment ID: I20231025001377 |
Provider Name | Bonnie Stevens |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932972056 PECOS PAC ID: 7810345014 Enrollment ID: I20231129000693 |
Provider Name | Sarah Bisognani |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356058077 PECOS PAC ID: 4082062211 Enrollment ID: I20231129002000 |
Provider Name | Emma Kwon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740053800 PECOS PAC ID: 3779935655 Enrollment ID: I20240116003157 |
Provider Name | Ahanth Vedantham |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1124605712 PECOS PAC ID: 4880047513 Enrollment ID: I20240130001664 |
Provider Name | Abdullah Zeeshan Farooqui |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629647169 PECOS PAC ID: 0547603136 Enrollment ID: I20240212000485 |
Provider Name | Fortunata Gelvolea Dabu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851084008 PECOS PAC ID: 7810331212 Enrollment ID: I20240213003843 |
Provider Name | Palwasha Ahmed |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1669051116 PECOS PAC ID: 7214374289 Enrollment ID: I20240326002512 |
Provider Name | Anthony Adjei |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760139018 PECOS PAC ID: 1658718580 Enrollment ID: I20240327000944 |
Provider Name | Daisy Cristina Cruz Arias |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497525570 PECOS PAC ID: 7810336195 Enrollment ID: I20240419000191 |
Provider Name | Carlene Del Castillo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699535971 PECOS PAC ID: 5496196495 Enrollment ID: I20240508001618 |
Provider Name | Lisa Kovtun |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922851245 PECOS PAC ID: 2769823673 Enrollment ID: I20240509001988 |
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 | |
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