| Presence Healthcare Services | |
|
800 Austin St Suite #451 East Tower Evanston IL 60202-3439 | |
| (847) 316-6611 | |
| (847) 316-6606 |
| Full Name | Presence Healthcare Services |
|---|---|
| Speciality | Internal Medicine |
| Location | 800 Austin St, Evanston, Illinois |
| Authorized Official Name and Position | Melvonne Wickliffe-jones (CREDENTIALING MGR) |
| Authorized Official Contact | 6309142417 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Presence Healthcare Services 1000 Remington Boulevard Bolingbrook IL 60440-0000 Ph: (630) 914-2417 | Presence Healthcare Services 800 Austin St Suite #451 East Tower Evanston IL 60202-3439 Ph: (847) 316-6611 |
| NPI Number | 1821191867 |
|---|---|
| Provider Enumeration Date | 09/06/2006 |
| Last Update Date | 04/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821191867 | NPI | - | NPPES |
| 036042217 | Medicaid | IL | |
| 036113363 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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