| Your Family Doctor, Llc | |
|
205 Cadillac Ct Ste 7 Belvidere IL 61008-1733 | |
| (815) 544-0087 | |
| (815) 544-0088 |
| Full Name | Your Family Doctor, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 205 Cadillac Ct Ste 7, Belvidere, Illinois |
| Authorized Official Name and Position | Therese Lucietto-sieradzki (OWNER) |
| Authorized Official Contact | 8155440087 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Family Doctor, Llc Po Box 298 Belvidere IL 61008-0298 Ph: (815) 544-0087 | Your Family Doctor, Llc 205 Cadillac Ct Ste 7 Belvidere IL 61008-1733 Ph: (815) 544-0087 |
| NPI Number | 1942219514 |
|---|---|
| Provider Enumeration Date | 08/05/2006 |
| Last Update Date | 03/31/2017 |
| Medicare PECOS PAC ID | 0446202568 |
|---|---|
| Medicare Enrollment ID | O20050217000359 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942219514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Therese M Lucietto-sieradzki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699708636 PECOS PAC ID: 5395706774 Enrollment ID: I20041019001296 |
| Provider Name | Sarah Bratcher Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568981561 PECOS PAC ID: 2365702933 Enrollment ID: I20180131001471 |
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Shobha S Iyengar, Md Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2186 Unit 1, North State Street, Belvidere, IL 61008 Phone: 815-547-5007 | |
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Clayton R. Malaker, M.d., S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 824 Van Buren St, Belvidere, IL 61008 Phone: 815-544-3481 | |
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Walgreen Co./ill. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 230 W Chrysler Dr, Belvidere, IL 61008 Phone: 815-544-4790 | |
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