| Alc Primary Care At Home | |
|
360 W Butterfield Rd Ste 325 Elmhurst IL 60126-5088 | |
| (312) 728-4728 | |
| (312) 728-4729 |
| Full Name | Alc Primary Care At Home |
|---|---|
| Speciality | Internal Medicine |
| Location | 360 W Butterfield Rd Ste 325, Elmhurst, Illinois |
| Authorized Official Name and Position | Jennifer Zamora (DIRECTOR) |
| Authorized Official Contact | 1312728472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alc Primary Care At Home 360 W Butterfield Rd Ste 325 Elmhurst IL 60126-5088 Ph: (312) 728-4728 | Alc Primary Care At Home 360 W Butterfield Rd Ste 325 Elmhurst IL 60126-5088 Ph: (312) 728-4728 |
| NPI Number | 1083195564 |
|---|---|
| Provider Enumeration Date | 08/23/2018 |
| Last Update Date | 02/13/2024 |
| Medicare PECOS PAC ID | 6709137854 |
|---|---|
| Medicare Enrollment ID | O20180928001311 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083195564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 253Z00000X | In Home Supportive Care | (* (Not Available)) | Secondary |
| Provider Name | John R Haebich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881647048 PECOS PAC ID: 2567596281 Enrollment ID: I20100817001210 |
| Provider Name | Chanel D Mesch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487151304 PECOS PAC ID: 8224372263 Enrollment ID: I20181203002101 |
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