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4747-51 West Cermak Rd Uih-mile Square Health Center At Cicero Cicero IL 60804-2508 | |
(708) 656-4766 | |
(312) 413-7812 |
Full Name | |
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Speciality | Clinic/Center |
Location | 4747-51 West Cermak Rd, Cicero, Illinois |
Authorized Official Name and Position | Henry Taylor (CEO) |
Authorized Official Contact | 3124131261 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1220 S. Wood Street Uih-mile Square Health Center Chicago IL 60608-1202 Ph: (312) 413-1261 | 4747-51 West Cermak Rd Uih-mile Square Health Center At Cicero Cicero IL 60804-2508 Ph: (708) 656-4766 |
NPI Number | 1407166671 |
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Provider Enumeration Date | 10/20/2010 |
Last Update Date | 12/17/2015 |
Medicare PECOS PAC ID | 3072422716 |
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Medicare Enrollment ID | O20120626000329 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407166671 | NPI | - | NPPES |
1622185 | Other | IL | BCBC PROVIDER |
1622185 | Other | IL | BCBS PROVIDER |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Roselia Herrera Md Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6039 W Cermak Rd, Cicero, IL 60804 Phone: 708-652-0056 | |
Mk Medical Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5729 W Cermak Rd, Cicero, IL 60804 Phone: 708-477-6525 | |
Hernan Reyes Md Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5610 W Cermak Rd, Unit #2, Cicero, IL 60804 Phone: 708-656-9247 Fax: 708-656-9358 | |