| Pure Family Healthcare | |
|
750 E Terra Cotta Ave Crystal Lake IL 60014-3621 | |
| (847) 639-5800 | |
| (815) 526-3467 |
| Full Name | Pure Family Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 750 E Terra Cotta Ave, Crystal Lake, Illinois |
| Authorized Official Name and Position | Chelsey Lesniak (PARTNER) |
| Authorized Official Contact | 2247237538 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pure Family Healthcare 750 E Terra Cotta Ave Crystal Lake IL 60014-3621 Ph: (847) 639-5800 | Pure Family Healthcare 750 E Terra Cotta Ave Crystal Lake IL 60014-3621 Ph: (847) 639-5800 |
| NPI Number | 1891376497 |
|---|---|
| Provider Enumeration Date | 04/16/2021 |
| Last Update Date | 04/26/2022 |
| Medicare PECOS PAC ID | 1052714805 |
|---|---|
| Medicare Enrollment ID | O20210730001961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891376497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Chelsey Lesniak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518434463 PECOS PAC ID: 1759626161 Enrollment ID: I20181212003361 |
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