| Zavala Internists, S.c. | |
|
1725 W Harrison St Suite 318 Chicago IL 60612-3841 | |
| (312) 942-6647 | |
| (312) 942-3740 |
| Full Name | Zavala Internists, S.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1725 W Harrison St, Chicago, Illinois |
| Authorized Official Name and Position | Gilberto Zavala (PRESIDENT OWNER) |
| Authorized Official Contact | 3129423747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Zavala Internists, S.c. 1725 W Harrison St Ste 318 Chicago IL 60612-3817 Ph: (312) 942-6647 | Zavala Internists, S.c. 1725 W Harrison St Suite 318 Chicago IL 60612-3841 Ph: (312) 942-6647 |
| NPI Number | 1013942283 |
|---|---|
| Provider Enumeration Date | 07/12/2006 |
| Last Update Date | 05/08/2020 |
| Medicare PECOS PAC ID | 8325933369 |
|---|---|
| Medicare Enrollment ID | O20040218000475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013942283 | NPI | - | NPPES |
| C30464 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Gilberto Zavala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699700872 PECOS PAC ID: 6709948631 Enrollment ID: I20100621000485 |
| Provider Name | Albene Kokocinski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053346221 PECOS PAC ID: 1557493780 Enrollment ID: I20100722000906 |
| Provider Name | Stasia Eileen Richter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508869744 PECOS PAC ID: 0446445910 Enrollment ID: I20101110000117 |
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