| Miinehealth, Inc. | |
|
4640 Sassafras Ln Naperville IL 60564-1139 | |
| (708) 690-6760 | |
| Not Available |
| Full Name | Miinehealth, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 4640 Sassafras Ln, Naperville, Illinois |
| Authorized Official Name and Position | Ashley Alix Rock (DIRECTOR) |
| Authorized Official Contact | 7086907870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miinehealth, Inc. 4640 Sassafras Ln Naperville IL 60564-1139 Ph: (708) 690-6760 | Miinehealth, Inc. 4640 Sassafras Ln Naperville IL 60564-1139 Ph: (708) 690-6760 |
| NPI Number | 1538862230 |
|---|---|
| Provider Enumeration Date | 03/23/2023 |
| Last Update Date | 05/08/2023 |
| Medicare PECOS PAC ID | 5193182715 |
|---|---|
| Medicare Enrollment ID | O20230613000477 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538862230 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Luciano Fochesatto Filho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356591549 PECOS PAC ID: 6406042522 Enrollment ID: I20101201000027 |
| Provider Name | Muhammad B Abushaer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942258983 PECOS PAC ID: 8022053495 Enrollment ID: I20130227000463 |
| Provider Name | Earl Hamilton Rudolph |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487851481 PECOS PAC ID: 2466641618 Enrollment ID: I20150113002515 |
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