| Rush Oak Park Physicians Group Anchor | |
|
610 S Maple Ave Suite 3900 Oak Park IL 60304-1091 | |
| (708) 524-1674 | |
| Not Available |
| Full Name | Rush Oak Park Physicians Group Anchor |
|---|---|
| Speciality | Family Medicine |
| Location | 610 S Maple Ave, Oak Park, Illinois |
| Authorized Official Name and Position | Scott A Halper (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 3129427770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rush Oak Park Physicians Group Anchor 610 S Maple Ave Suite 3900 Oak Park IL 60304-1091 Ph: (708) 524-1674 | Rush Oak Park Physicians Group Anchor 610 S Maple Ave Suite 3900 Oak Park IL 60304-1091 Ph: (708) 524-1674 |
| NPI Number | 1396018453 |
|---|---|
| Provider Enumeration Date | 02/20/2012 |
| Last Update Date | 06/04/2024 |
| Medicare PECOS PAC ID | 7719148378 |
|---|---|
| Medicare Enrollment ID | O20120502000726 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396018453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| 207R00000X | Internal Medicine | (Illinois) | Secondary |
| 208000000X | Pediatrics | (Illinois) | Secondary |
| Provider Name | Damien John Mcknight |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871688853 PECOS PAC ID: 0244223444 Enrollment ID: I20040405000942 |
| Provider Name | Carolyn Elaine Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205872462 PECOS PAC ID: 9739107467 Enrollment ID: I20051110000507 |
| Provider Name | Maimoona M Shah |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265482640 PECOS PAC ID: 3678627718 Enrollment ID: I20090824000677 |
| Provider Name | Philip S Palutsis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578521902 PECOS PAC ID: 2163524950 Enrollment ID: I20100616000563 |
| Provider Name | Catherine E Mcginness |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518917939 PECOS PAC ID: 4082745120 Enrollment ID: I20100706000413 |
| Provider Name | Kristopher K Carpenter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437305190 PECOS PAC ID: 6608990650 Enrollment ID: I20100827000946 |
| Provider Name | Theresa M Havalad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942649181 PECOS PAC ID: 1557595105 Enrollment ID: I20131014001613 |
| Provider Name | Emily L Casselbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245636372 PECOS PAC ID: 8426373655 Enrollment ID: I20150211000750 |
| Provider Name | Yesenia Valdez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871936146 PECOS PAC ID: 4981914090 Enrollment ID: I20160113002020 |
| Provider Name | Katie L. Meador |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255754040 PECOS PAC ID: 0042504672 Enrollment ID: I20160804001638 |
| Provider Name | Niketa A Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427498732 PECOS PAC ID: 2860740677 Enrollment ID: I20180809004604 |
| Provider Name | Amita Goyal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316338239 PECOS PAC ID: 8426358763 Enrollment ID: I20181029002786 |
| Provider Name | Carol M Stanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730628678 PECOS PAC ID: 3375881485 Enrollment ID: I20190215001107 |
| Provider Name | Sara Mahmoud Mousa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184152118 PECOS PAC ID: 5395016463 Enrollment ID: I20230516002483 |
| Provider Name | Kelly M King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447962378 PECOS PAC ID: 2365803624 Enrollment ID: I20230802002893 |
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