| Millennium Park Medical Associates, S.c. | |
|
30 S Michigan Ave Ste 500 Chicago IL 60603-3205 | |
| (312) 977-1185 | |
| (312) 977-1188 |
| Full Name | Millennium Park Medical Associates, S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 30 S Michigan Ave Ste 500, Chicago, Illinois |
| Authorized Official Name and Position | Farah N Khan (OWNER, CEO) |
| Authorized Official Contact | 3129771185 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Millennium Park Medical Associates, S.c. 30 S Michigan Ave Suite #500 Chicago IL 60603-3211 Ph: (312) 977-1185 | Millennium Park Medical Associates, S.c. 30 S Michigan Ave Ste 500 Chicago IL 60603-3205 Ph: (312) 977-1185 |
| NPI Number | 1700073780 |
|---|---|
| Provider Enumeration Date | 10/03/2007 |
| Last Update Date | 10/18/2023 |
| Medicare PECOS PAC ID | 3678505096 |
|---|---|
| Medicare Enrollment ID | O20050907000471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700073780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 036103943 (Illinois) | Primary |
| Provider Name | Farah N Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861434896 PECOS PAC ID: 0244267037 Enrollment ID: I20050723000054 |
| Provider Name | Brittany Graft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205373461 PECOS PAC ID: 3870850795 Enrollment ID: I20171201000988 |
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