| Yigazu Wellness Clinic S.c. | |
|
2143 W Wellington Ave Suite 100 Chicago IL 60618-8268 | |
| (773) 528-8400 | |
| Not Available |
| Full Name | Yigazu Wellness Clinic S.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2143 W Wellington Ave, Chicago, Illinois |
| Authorized Official Name and Position | Solomon Yigazu (OWNER) |
| Authorized Official Contact | 7735285400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yigazu Wellness Clinic S.c. 3660 N Lake Shore Dr Suite 3601 Chicago IL 60613-5300 Ph: () - | Yigazu Wellness Clinic S.c. 2143 W Wellington Ave Suite 100 Chicago IL 60618-8268 Ph: (773) 528-8400 |
| NPI Number | 1225432297 |
|---|---|
| Provider Enumeration Date | 10/20/2014 |
| Last Update Date | 01/28/2015 |
| Medicare PECOS PAC ID | 6709100621 |
|---|---|
| Medicare Enrollment ID | O20150126001035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225432297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Solomon M Yigazu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376539221 PECOS PAC ID: 9830158492 Enrollment ID: I20041008000177 |
| Provider Name | Lettricia R Gunaratnam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851449060 PECOS PAC ID: 8325162613 Enrollment ID: I20100823000994 |
| Provider Name | Sonam Shokso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730566779 PECOS PAC ID: 7517278575 Enrollment ID: I20150617000426 |
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