| Evohealthmd | |
|
3530 W Peterson Ave Ste 101 Chicago IL 60659-3294 | |
| (312) 857-6894 | |
| (773) 442-0978 |
| Full Name | Evohealthmd |
|---|---|
| Speciality | General Practice |
| Location | 3530 W Peterson Ave Ste 101, Chicago, Illinois |
| Authorized Official Name and Position | Keesha Eguia (COO) |
| Authorized Official Contact | 2143108275 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evohealthmd 3530 W Peterson Ave Ste 101 Chicago IL 60659-3294 Ph: (800) 766-0666 | Evohealthmd 3530 W Peterson Ave Ste 101 Chicago IL 60659-3294 Ph: (312) 857-6894 |
| NPI Number | 1588293633 |
|---|---|
| Provider Enumeration Date | 04/01/2020 |
| Last Update Date | 07/19/2024 |
| Medicare PECOS PAC ID | 1153736442 |
|---|---|
| Medicare Enrollment ID | O20230601002015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588293633 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 251E00000X | Home Health | (* (Not Available)) | Secondary |
| Provider Name | Abby E Mcmahon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811144629 PECOS PAC ID: 4385703776 Enrollment ID: I20081029000794 |
| Provider Name | Candice E Meck |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518265875 PECOS PAC ID: 5395965404 Enrollment ID: I20141117001234 |
| Provider Name | Teshica Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114374139 PECOS PAC ID: 7517251606 Enrollment ID: I20160812000605 |
| Provider Name | Elizabeth Z Gussis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861900789 PECOS PAC ID: 6507111507 Enrollment ID: I20181129001161 |
| Provider Name | Elizabette Nava |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861970642 PECOS PAC ID: 5597197145 Enrollment ID: I20191120000189 |
| Provider Name | Tamara Lynn Paradies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265194047 PECOS PAC ID: 5496002479 Enrollment ID: I20220112000728 |
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