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4711 Golf Rd Ste 920 Skokie IL 60076-1224 | |
| (855) 729-2272 | |
| (224) 330-1064 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 4711 Golf Rd Ste 920, Skokie, Illinois |
| Authorized Official Name and Position | Melissa Grant (COO) |
| Authorized Official Contact | 2025304170 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1001 Connecticut Ave Nw Ste 805 Washington DC 20036-5536 Ph: (202) 530-4173 | 4711 Golf Rd Ste 920 Skokie IL 60076-1224 Ph: (855) 729-2272 |
| NPI Number | 1417428889 |
|---|---|
| Provider Enumeration Date | 12/11/2018 |
| Last Update Date | 12/20/2024 |
| Medicare PECOS PAC ID | 1254659204 |
|---|---|
| Medicare Enrollment ID | O20190418000565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417428889 | NPI | - | NPPES |
| Provider Name | Kimberly T Remski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073930137 PECOS PAC ID: 0143530352 Enrollment ID: I20161207002810 |
| Provider Name | Susan C Haskell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598735102 PECOS PAC ID: 5597790089 Enrollment ID: I20190418001522 |
| Provider Name | Cassie N Speck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578968244 PECOS PAC ID: 2860876315 Enrollment ID: I20230216002377 |
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