| Phoenix Medical Associates, P.c. | |
|
3718 N Ashland Ave Chicago IL 60613-4793 | |
| (773) 327-9900 | |
| (773) 327-0589 |
| Full Name | Phoenix Medical Associates, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 3718 N Ashland Ave, Chicago, Illinois |
| Authorized Official Name and Position | Florian Miranzadeh (PRESIDENT / OWNER) |
| Authorized Official Contact | 7733279900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Medical Associates, P.c. 777 Oakmont Ln Suite 1600 Westmont IL 60559-5511 Ph: (630) 789-2550 | Phoenix Medical Associates, P.c. 3718 N Ashland Ave Chicago IL 60613-4793 Ph: (773) 327-9900 |
| NPI Number | 1558396580 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 02/23/2010 |
| Medicare PECOS PAC ID | 6406805522 |
|---|---|
| Medicare Enrollment ID | O20050115000033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558396580 | NPI | - | NPPES |
| 01629934 | Other | IL | BCBS PROVIDER ID |
| 4010133 | Other | IL | ADVOCATE IL MASONIC ID |
| 080171110 | Other | IL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 36100398 (Illinois) | Primary |
| Provider Name | B Florian Florian Miranzadeh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609862135 PECOS PAC ID: 3678522794 Enrollment ID: I20070621000558 |
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