| Mj Medical Group Sc | |
|
6326 N Lincoln Ave Chicago IL 60659-1204 | |
| (773) 463-4100 | |
| (773) 463-4102 |
| Full Name | Mj Medical Group Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 6326 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | Michael H Jutovsky (CEO) |
| Authorized Official Contact | 7734634100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mj Medical Group Sc 6326 N Lincoln Ave Chicago IL 60659-1204 Ph: (773) 463-4100 | Mj Medical Group Sc 6326 N Lincoln Ave Chicago IL 60659-1204 Ph: (773) 463-4100 |
| NPI Number | 1649224148 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 08/23/2011 |
| Medicare PECOS PAC ID | 0345258018 |
|---|---|
| Medicare Enrollment ID | O20060323000081 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649224148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| Provider Name | Marina Claudio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881627198 PECOS PAC ID: 4789666207 Enrollment ID: I20040607000935 |
| Provider Name | Michael H Jutovsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497756605 PECOS PAC ID: 8527076207 Enrollment ID: I20070625000440 |
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