| Valley West Medical Center, S.c. | |
|
1200 W South St Plano IL 60545-1790 | |
| (630) 552-7601 | |
| (630) 552-9215 |
| Full Name | Valley West Medical Center, S.c. |
|---|---|
| Speciality | Surgery |
| Location | 1200 W South St, Plano, Illinois |
| Authorized Official Name and Position | Jose G. Trevino (PRESIDENT) |
| Authorized Official Contact | 6305527601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley West Medical Center, S.c. 1200 W South St Plano IL 60545-1790 Ph: (630) 552-7601 | Valley West Medical Center, S.c. 1200 W South St Plano IL 60545-1790 Ph: (630) 552-7601 |
| NPI Number | 1013191097 |
|---|---|
| Provider Enumeration Date | 12/26/2007 |
| Last Update Date | 08/01/2023 |
| Medicare PECOS PAC ID | 4284717539 |
|---|---|
| Medicare Enrollment ID | O20080211000445 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013191097 | NPI | - | NPPES |
| 4722870 | Other | IL | BLUE CROSS/BLUE SHIELD |
| 036061677 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208600000X | Surgery | (* (Not Available)) | Primary |
| Provider Name | Jose G Trevino |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609941319 PECOS PAC ID: 6901867654 Enrollment ID: I20080211000334 |
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