| Universal Health, Ltd | |
|
1007 W Lawrence Ave Chicago IL 60640-5017 | |
| (773) 271-1500 | |
| (773) 271-2048 |
| Full Name | Universal Health, Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 1007 W Lawrence Ave, Chicago, Illinois |
| Authorized Official Name and Position | Olga Mavashev (OFFICE MANAGER) |
| Authorized Official Contact | 7732711500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Universal Health, Ltd 994 Coventry Ln Highland Park IL 60035-3748 Ph: (773) 271-1500 | Universal Health, Ltd 1007 W Lawrence Ave Chicago IL 60640-5017 Ph: (773) 271-1500 |
| NPI Number | 1891975512 |
|---|---|
| Provider Enumeration Date | 11/09/2007 |
| Last Update Date | 10/13/2020 |
| Medicare PECOS PAC ID | 6709785801 |
|---|---|
| Medicare Enrollment ID | O20040107000948 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891975512 | NPI | - | NPPES |
| 036101294 | Medicaid | IL | |
| 01626490 | Other | IL | BCBS |
| 036101294 | Other | IL | LISENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036101294 (Illinois) | Primary |
| Provider Name | Feliks S Mavashev |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215946603 PECOS PAC ID: 9335048446 Enrollment ID: I20040108000470 |
| Provider Name | Olga Meltser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780458174 PECOS PAC ID: 0648712810 Enrollment ID: I20240604002230 |
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