My Family Doc Llc | |
2001-03 Essington Rd Joliet IL 60435 | |
(815) 733-6888 | |
(815) 733-6890 |
Full Name | My Family Doc Llc |
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Speciality | Family Medicine |
Location | 2001-03 Essington Rd, Joliet, Illinois |
Authorized Official Name and Position | Molly D'costa (OWNER, PHYSICIAN) |
Authorized Official Contact | 8157336888 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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My Family Doc Llc 2001-03 Essington Rd Joliet IL 60435 Ph: (815) 733-6888 | My Family Doc Llc 2001-03 Essington Rd Joliet IL 60435 Ph: (815) 733-6888 |
NPI Number | 1528489739 |
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Provider Enumeration Date | 12/16/2013 |
Last Update Date | 11/03/2023 |
Medicare PECOS PAC ID | 6901037951 |
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Medicare Enrollment ID | O20140317000367 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528489739 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036116813 (Illinois) | Primary |
Provider Name | Molly M Dcosta |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1033199369 PECOS PAC ID: 8921097395 Enrollment ID: I20061130000203 |
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