| Whole Health Md Llc | |
|
2266 N Lincoln Ave Suite 300 Chicago IL 60614-7600 | |
| (847) 293-0901 | |
| Not Available |
| Full Name | Whole Health Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2266 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | Ann Delacruz (MANAGER) |
| Authorized Official Contact | 8472930901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whole Health Md Llc 2266 N Lincoln Ave Suite 300 Chicago IL 60614-7600 Ph: (847) 293-0901 | Whole Health Md Llc 2266 N Lincoln Ave Suite 300 Chicago IL 60614-7600 Ph: (847) 293-0901 |
| NPI Number | 1366724577 |
|---|---|
| Provider Enumeration Date | 09/13/2011 |
| Last Update Date | 09/23/2011 |
| Medicare PECOS PAC ID | 7012133077 |
|---|---|
| Medicare Enrollment ID | O20140728001462 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366724577 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marco A Delacruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528110228 PECOS PAC ID: 6507982436 Enrollment ID: I20100928000903 |
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