| Chmg - Lakefront | |
|
4700 N Marine Dr Ste 300 Chicago IL 60640-7975 | |
| (844) 533-2464 | |
| Not Available |
| Full Name | Chmg - Lakefront |
|---|---|
| Speciality | Internal Medicine |
| Location | 4700 N Marine Dr Ste 300, Chicago, Illinois |
| Authorized Official Name and Position | Manoj Prasad (CEO) |
| Authorized Official Contact | 7087636700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chmg - Lakefront 4646 N Marine Dr Chicago IL 60640-5759 Ph: () - | Chmg - Lakefront 4700 N Marine Dr Ste 300 Chicago IL 60640-7975 Ph: (844) 533-2464 |
| NPI Number | 1013480359 |
|---|---|
| Provider Enumeration Date | 01/09/2019 |
| Last Update Date | 12/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013480359 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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