New Southtown Medical Group S C | |
8205 Cass Ave Ste 110b Darien IL 60561-5319 | |
(773) 840-4747 | |
(773) 634-7970 |
Full Name | New Southtown Medical Group S C |
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Speciality | Family Medicine |
Location | 8205 Cass Ave Ste 110b, Darien, Illinois |
Authorized Official Name and Position | Bianca N Chalokwu (PRESIDENT) |
Authorized Official Contact | 7738404747 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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New Southtown Medical Group S C 8205 Cass Ave Ste 110b Darien IL 60561-5319 Ph: (773) 840-4747 | New Southtown Medical Group S C 8205 Cass Ave Ste 110b Darien IL 60561-5319 Ph: (773) 840-4747 |
NPI Number | 1134508997 |
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Provider Enumeration Date | 05/27/2015 |
Last Update Date | 08/19/2024 |
Medicare PECOS PAC ID | 0547572349 |
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Medicare Enrollment ID | O20150708001267 |
Identifier | Type | State | Issuer |
---|---|---|---|
1134508997 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Cesar Augusto Carranza |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1447207022 PECOS PAC ID: 3779473996 Enrollment ID: I20040319000180 |
Provider Name | Rita J Mcguire |
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Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1780634733 PECOS PAC ID: 5698748853 Enrollment ID: I20040816001135 |
Provider Name | Rhonda Y Gans |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003830670 PECOS PAC ID: 2961465794 Enrollment ID: I20041111000648 |
Provider Name | Olusoji A Peter |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1225018203 PECOS PAC ID: 2264514561 Enrollment ID: I20080726000013 |
Provider Name | Christian Oyibe |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528423019 PECOS PAC ID: 3375845027 Enrollment ID: I20160112001902 |
Provider Name | Jamilah F Johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154796605 PECOS PAC ID: 7113223769 Enrollment ID: I20160309000240 |
Provider Name | Asantewah F Daniels |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083076871 PECOS PAC ID: 7719285840 Enrollment ID: I20160406000452 |
Provider Name | Delovely G Jackson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013370857 PECOS PAC ID: 9133418627 Enrollment ID: I20160524000140 |
Provider Name | Leshaun Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043679681 PECOS PAC ID: 0941580823 Enrollment ID: I20161212000651 |
Provider Name | Sherree Mccool |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104354257 PECOS PAC ID: 5799041059 Enrollment ID: I20171102002562 |
Provider Name | Taryrsha Davis |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821552761 PECOS PAC ID: 7911246368 Enrollment ID: I20190228002263 |
Provider Name | Folarin Opakunle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952879777 PECOS PAC ID: 7719025469 Enrollment ID: I20190514003122 |
Provider Name | Chakika Williams |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770047615 PECOS PAC ID: 1355676974 Enrollment ID: I20190718000300 |
Provider Name | Sylvere Roland Malonga |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497311104 PECOS PAC ID: 1557272796 Enrollment ID: I20200529000009 |
Provider Name | Ismail Adebayo Oyebode |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669079018 PECOS PAC ID: 0547673220 Enrollment ID: I20210120000584 |
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