| Vancol Family Health Center Sc | |
|
67 W 111th St Suite 302 Chicago IL 60628-4247 | |
| (773) 575-7447 | |
| Not Available |
| Full Name | Vancol Family Health Center Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 67 W 111th St, Chicago, Illinois |
| Authorized Official Name and Position | Rosita Doyle (BILLING CONSULTANT) |
| Authorized Official Contact | 7738469521 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vancol Family Health Center Sc 8646 S Saginaw Ave Chicago IL 60617-2422 Ph: (773) 575-7447 | Vancol Family Health Center Sc 67 W 111th St Suite 302 Chicago IL 60628-4247 Ph: (773) 575-7447 |
| NPI Number | 1477723823 |
|---|---|
| Provider Enumeration Date | 03/01/2008 |
| Last Update Date | 03/19/2008 |
| Medicare PECOS PAC ID | 2668559055 |
|---|---|
| Medicare Enrollment ID | O20080409000598 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477723823 | NPI | - | NPPES |
| 0001633398 | Other | IL | BLUECROSS BLUESHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| Provider Name | Carl Vancol |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245222454 PECOS PAC ID: 9739186966 Enrollment ID: I20061101000490 |
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