| Westeros Family Practice, Ltd | |
|
366 E Burlington St Riverside IL 60546-2152 | |
| (708) 442-7174 | |
| Not Available |
| Full Name | Westeros Family Practice, Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 366 E Burlington St, Riverside, Illinois |
| Authorized Official Name and Position | Iryna Serembytsky (PRESIDENT) |
| Authorized Official Contact | 7084427174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Westeros Family Practice, Ltd 366 E Burlington St Riverside IL 60546-2152 Ph: (708) 442-7174 | Westeros Family Practice, Ltd 366 E Burlington St Riverside IL 60546-2152 Ph: (708) 442-7174 |
| NPI Number | 1780131227 |
|---|---|
| Provider Enumeration Date | 09/01/2016 |
| Last Update Date | 04/13/2023 |
| Medicare PECOS PAC ID | 8325327463 |
|---|---|
| Medicare Enrollment ID | O20161114001561 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780131227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036136127 (Illinois) | Primary |
| Provider Name | Iryna Serembytsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134415979 PECOS PAC ID: 6305066226 Enrollment ID: I20140927000319 |
| Provider Name | Yanet Acosta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184911067 PECOS PAC ID: 3870713597 Enrollment ID: I20141001001293 |
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