| Michigan Avenue Immediate Care | |
|
180 N Michigan Ave Suite 1605 Chicago IL 60601-7478 | |
| (312) 201-1234 | |
| (312) 201-1202 |
| Full Name | Michigan Avenue Immediate Care |
|---|---|
| Speciality | Family Medicine |
| Location | 180 N Michigan Ave, Chicago, Illinois |
| Authorized Official Name and Position | James A Runke (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3122011234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Avenue Immediate Care 180 N Michigan Ave Suite 1605 Chicago IL 60601-7478 Ph: (312) 201-1234 | Michigan Avenue Immediate Care 180 N Michigan Ave Suite 1605 Chicago IL 60601-7478 Ph: (312) 201-1234 |
| NPI Number | 1174658694 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 11/01/2012 |
| Medicare PECOS PAC ID | 9436296076 |
|---|---|
| Medicare Enrollment ID | O20091030000053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174658694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 042.616731 (Illinois) | Primary |
| Provider Name | Mona M Clor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932182003 PECOS PAC ID: 4688571821 Enrollment ID: I20031216000816 |
| Provider Name | James T Barrett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407863210 PECOS PAC ID: 5991697971 Enrollment ID: I20040325001025 |
| Provider Name | Joshua R Merok |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063685451 PECOS PAC ID: 1850451543 Enrollment ID: I20081126000098 |
| Provider Name | James A Runke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952425035 PECOS PAC ID: 6800933441 Enrollment ID: I20091030000043 |
| Provider Name | Ulrike Z Lengyel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790983831 PECOS PAC ID: 3971784679 Enrollment ID: I20110301000709 |
| Provider Name | Michael E Kupkowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598081598 PECOS PAC ID: 2466684048 Enrollment ID: I20140414000998 |
| Provider Name | Jeanette Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154769081 PECOS PAC ID: 7810120714 Enrollment ID: I20160713002781 |
| Provider Name | Shira G Kazzaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144744095 PECOS PAC ID: 8325306145 Enrollment ID: I20171227000452 |
| Provider Name | Carrie Lynn Salvia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144675596 PECOS PAC ID: 3173813508 Enrollment ID: I20190719001841 |
| Provider Name | Margaret S. Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003380148 PECOS PAC ID: 5395178248 Enrollment ID: I20191206000296 |
| Provider Name | Lauren Landerholm Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790280881 PECOS PAC ID: 2365847704 Enrollment ID: I20210823001892 |
| Provider Name | Anne-sophie Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285195396 PECOS PAC ID: 1254756760 Enrollment ID: I20231027002433 |
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