Orchard Medical Center Sc | |
543 Orchard St Orchard Medical Center Sc Antioch IL 60002-3107 | |
(847) 395-3322 | |
(847) 395-0921 |
Full Name | Orchard Medical Center Sc |
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Speciality | Family Medicine |
Location | 543 Orchard St, Antioch, Illinois |
Authorized Official Name and Position | Ashley Matus (PRACTICE ADMINISTRATOR) |
Authorized Official Contact | 8473953322 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Orchard Medical Center Sc 543 Orchard St Orchard Medical Center Sc Antioch IL 60002-3107 Ph: (847) 395-3322 | Orchard Medical Center Sc 543 Orchard St Orchard Medical Center Sc Antioch IL 60002-3107 Ph: (847) 395-3322 |
NPI Number | 1306835491 |
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Provider Enumeration Date | 10/20/2005 |
Last Update Date | 12/11/2019 |
Medicare PECOS PAC ID | 9133154610 |
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Medicare Enrollment ID | O20051004000283 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306835491 | NPI | - | NPPES |
637760 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Elizabeth Soifer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1184843328 PECOS PAC ID: 1557446572 Enrollment ID: I20080314000063 |
Provider Name | John J Devaney |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538152327 PECOS PAC ID: 9830124312 Enrollment ID: I20100213000012 |
Provider Name | Guy R Abderholden |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1902899792 PECOS PAC ID: 7012942592 Enrollment ID: I20100213000020 |
Provider Name | Sophie Huang |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1386264653 PECOS PAC ID: 5193191708 Enrollment ID: I20221024001828 |
Provider Name | Raquel Mejos |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114516754 PECOS PAC ID: 3375952435 Enrollment ID: I20230717001519 |