| Northwest Chicago Primary Care Sc | |
|
5641 W Irving Park Rd Chicago IL 60634-2742 | |
| (773) 635-5700 | |
| (773) 635-5050 |
| Full Name | Northwest Chicago Primary Care Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5641 W Irving Park Rd, Chicago, Illinois |
| Authorized Official Name and Position | Charlemagne G Guerrero (PRESIDENT) |
| Authorized Official Contact | 7735040727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Chicago Primary Care Sc 2900 N 76th Ct Elmwood Park IL 60707-1101 Ph: (773) 635-5700 | Northwest Chicago Primary Care Sc 5641 W Irving Park Rd Chicago IL 60634-2742 Ph: (773) 635-5700 |
| NPI Number | 1962760017 |
|---|---|
| Provider Enumeration Date | 04/26/2012 |
| Last Update Date | 09/10/2013 |
| Medicare PECOS PAC ID | 6608030812 |
|---|---|
| Medicare Enrollment ID | O20120619000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962760017 | NPI | - | NPPES |
| DT5494 | Other | IL | RAILROAD MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036124775 (Illinois) | Primary |
| Provider Name | Charlemagne G Guerrero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871715540 PECOS PAC ID: 5294920401 Enrollment ID: I20101113000218 |
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