| Raphael Medical Services Corp. | |
|
4646 N Marine Dr Ste C6300 Chicago IL 60640-5759 | |
| (773) 564-5781 | |
| Not Available |
| Full Name | Raphael Medical Services Corp. |
|---|---|
| Speciality | Family Medicine |
| Location | 4646 N Marine Dr Ste C6300, Chicago, Illinois |
| Authorized Official Name and Position | Tade Akere (MANAGER) |
| Authorized Official Contact | 7735645781 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Raphael Medical Services Corp. 1516 Fowler Ave Evanston IL 60201-3955 Ph: (773) 564-5781 | Raphael Medical Services Corp. 4646 N Marine Dr Ste C6300 Chicago IL 60640-5759 Ph: (773) 564-5781 |
| NPI Number | 1326517814 |
|---|---|
| Provider Enumeration Date | 11/14/2018 |
| Last Update Date | 06/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326517814 | NPI | - | NPPES |
| 036094343 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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