Premier Medspa | |
1311 Butterfield Rd Ste 306 Downers Grove IL 60515-5666 | |
(630) 445-1022 | |
Not Available |
Full Name | Premier Medspa |
---|---|
Speciality | Family Medicine |
Location | 1311 Butterfield Rd Ste 306, Downers Grove, Illinois |
Authorized Official Name and Position | Ridha Chakeer (PRESIDENT) |
Authorized Official Contact | 6302763291 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Premier Medspa 9051 Willow Ridge Dr Willow Springs IL 60480-1185 Ph: (630) 276-3291 | Premier Medspa 1311 Butterfield Rd Ste 306 Downers Grove IL 60515-5666 Ph: (630) 445-1022 |
NPI Number | 1649634247 |
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Provider Enumeration Date | 04/09/2016 |
Last Update Date | 04/17/2023 |
Medicare PECOS PAC ID | 9638468010 |
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Medicare Enrollment ID | O20160525002198 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649634247 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
Provider Name | Ridha M Chakeer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013164391 PECOS PAC ID: 1951568724 Enrollment ID: I20120206000824 |
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