| Md Family Medical Practice Llc | |
|
7425 W Irving Park Rd Chicago IL 60634-2139 | |
| (847) 975-6263 | |
| (888) 907-8030 |
| Full Name | Md Family Medical Practice Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7425 W Irving Park Rd, Chicago, Illinois |
| Authorized Official Name and Position | Maria Derylo (DNP) |
| Authorized Official Contact | 8479756263 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Md Family Medical Practice Llc 1924 Highland Ave Northbrook IL 60062-5020 Ph: (847) 975-6263 | Md Family Medical Practice Llc 7425 W Irving Park Rd Chicago IL 60634-2139 Ph: (847) 975-6263 |
| NPI Number | 1285216242 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 04/28/2021 |
| Medicare PECOS PAC ID | 9234538513 |
|---|---|
| Medicare Enrollment ID | O20210519001956 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285216242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Maria Derylo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316251176 PECOS PAC ID: 9931388857 Enrollment ID: I20110125000499 |
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