|
| |
|
3530 W Peterson Ave Ste 101 Chicago IL 60659-3294 | |
| (312) 857-6894 | |
| (773) 442-0978 |
| Full Name | |
|---|---|
| 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 |
|---|---|
3530 W Peterson Ave Ste 101 Chicago IL 60659-3294 Ph: (800) 766-0666 | 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 | 11/15/2024 |
| 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 | Naomi Lockett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235536350 PECOS PAC ID: 1951626266 Enrollment ID: I20150209001171 |
| Provider Name | Teshica Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114374139 PECOS PAC ID: 7517251606 Enrollment ID: I20160812000605 |
| Provider Name | Oludayo O Ojelade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245774306 PECOS PAC ID: 2163607797 Enrollment ID: I20170911000237 |
| Provider Name | Elizabeth Gussis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861900789 PECOS PAC ID: 6507111507 Enrollment ID: I20181129001161 |
| Provider Name | Keisha D. Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518524032 PECOS PAC ID: 1557696044 Enrollment ID: I20190703002217 |
| 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 |
| Provider Name | Scott Frederick Zingsheim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306544820 PECOS PAC ID: 2769847839 Enrollment ID: I20230424002480 |
| Provider Name | Dean Michael Villon Gorospe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265117204 PECOS PAC ID: 1759742943 Enrollment ID: I20230803004107 |
| Provider Name | Diana Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992482160 PECOS PAC ID: 6507302163 Enrollment ID: I20240719001648 |
| Provider Name | Carmen Carrabis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023359189 PECOS PAC ID: 0446494082 Enrollment ID: I20240801004264 |
| Provider Name | Nunta Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609259183 PECOS PAC ID: 4587972047 Enrollment ID: I20241002000085 |
Pilsen Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1952 W Cermak Rd, Chicago, IL 60608 Phone: 773-254-6611 Fax: 773-254-8590 | |
A Kavaliunas Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5540 S Pulaski Rd, Chicago, IL 60629 Phone: 773-585-2802 | |
Doc Cam Medical Center Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2315 E 93rd St Ste 337, Chicago, IL 60617 Phone: 773-731-2700 Fax: 773-373-1868 | |
Excellent Eye Care Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5352 N Milwaukee Ave, Chicago, IL 60630 Phone: 773-777-7444 Fax: 773-775-4030 | |
Pediatric General Care & Research Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4527 N Pulaski Rd, Chicago, IL 60630 Phone: 773-267-7060 Fax: 773-267-4752 | |
Urban Family Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10830 S Halsted St, Chicago, IL 60628 Phone: 773-264-1400 Fax: 773-264-1401 | |
Premier Primary Care And Alternative Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1301 E 47th Street, Bldg 2 Suite B, Chicago, IL 60653 Phone: 773-891-2890 Fax: 773-891-4107 |