| Rush Oak Park Physicians Group Family Medicine | |
|
610 S Maple Ave Suite 2500 Oak Park IL 60304-1091 | |
| (708) 660-2900 | |
| Not Available |
| Full Name | Rush Oak Park Physicians Group Family Medicine |
|---|---|
| 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 Family Medicine 610 S Maple Ave Suite 2500 Oak Park IL 60304-1091 Ph: (708) 660-2900 | Rush Oak Park Physicians Group Family Medicine 610 S Maple Ave Suite 2500 Oak Park IL 60304-1091 Ph: (708) 660-2900 |
| NPI Number | 1194096610 |
|---|---|
| Provider Enumeration Date | 01/13/2012 |
| Last Update Date | 06/04/2024 |
| Medicare PECOS PAC ID | 3274797139 |
|---|---|
| Medicare Enrollment ID | O20120606000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194096610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| Provider Name | Lashonda D Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023102472 PECOS PAC ID: 1456348085 Enrollment ID: I20040427000699 |
| Provider Name | Lucy Richman Fox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427038033 PECOS PAC ID: 6103831987 Enrollment ID: I20060215000502 |
| Provider Name | Donald S Childs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750361333 PECOS PAC ID: 4981500923 Enrollment ID: I20080826000404 |
| Provider Name | Keri L Fair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003073735 PECOS PAC ID: 0446327738 Enrollment ID: I20080929000625 |
| Provider Name | Linda Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093974792 PECOS PAC ID: 3375738115 Enrollment ID: I20101105001320 |
| Provider Name | Jordanna Y Matsoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740546282 PECOS PAC ID: 2466600739 Enrollment ID: I20120911000322 |
| Provider Name | Gina V. Medalle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164703310 PECOS PAC ID: 1658681523 Enrollment ID: I20151104002184 |
| Provider Name | Alexander M Neuman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295114668 PECOS PAC ID: 6507114170 Enrollment ID: I20180731000014 |
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