| Trv - Family Medicine, Ltd. | |
|
2740 W Foster Ave Suite 214 Chicago IL 60625-3500 | |
| (773) 506-2000 | |
| (773) 506-2668 |
| Full Name | Trv - Family Medicine, Ltd. |
|---|---|
| Speciality | Family Medicine |
| Location | 2740 W Foster Ave, Chicago, Illinois |
| Authorized Official Name and Position | Tony R. Vancauwelaert (PRESIDENT) |
| Authorized Official Contact | 7735062000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trv - Family Medicine, Ltd. 2740 W Foster Ave Suite 214 Chicago IL 60625-3500 Ph: (773) 506-2000 | Trv - Family Medicine, Ltd. 2740 W Foster Ave Suite 214 Chicago IL 60625-3500 Ph: (773) 506-2000 |
| NPI Number | 1992811178 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 02/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992811178 | NPI | - | NPPES |
| 036092385 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036092385 (Illinois) | Primary |
| 207QA0000X | Family Medicine - Adolescent Medicine | 036092385 (Illinois) | Secondary |
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