| Chmg - Edgewater | |
|
6201 North Broadway Chicago IL 60660 | |
| (844) 533-2464 | |
| Not Available |
| Full Name | Chmg - Edgewater |
|---|---|
| Speciality | Family Medicine |
| Location | 6201 North Broadway, 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 - Edgewater 4646 N Marine Dr Chicago IL 60640-5759 Ph: () - | Chmg - Edgewater 6201 North Broadway Chicago IL 60660 Ph: (844) 533-2464 |
| NPI Number | 1912470105 |
|---|---|
| Provider Enumeration Date | 01/10/2019 |
| Last Update Date | 01/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912470105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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