Zigma Visiting Physician, Llc | |
4 N Deer Point Dr 1002 Hainesville IL 60030 | |
(847) 946-0198 | |
(847) 972-6265 |
Full Name | Zigma Visiting Physician, Llc |
---|---|
Speciality | General Practice |
Location | 4 N Deer Point Dr, Hainesville, Illinois |
Authorized Official Name and Position | Evillo M Domingo (PRESIDENT) |
Authorized Official Contact | 5672246045 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Zigma Visiting Physician, Llc 4 N Deer Point Dr 1002 Hainesville IL 60030-3814 Ph: (847) 946-0198 | Zigma Visiting Physician, Llc 4 N Deer Point Dr 1002 Hainesville IL 60030 Ph: (847) 946-0198 |
NPI Number | 1093175804 |
---|---|
Provider Enumeration Date | 03/07/2016 |
Last Update Date | 09/26/2019 |
Medicare PECOS PAC ID | 0547566994 |
---|---|
Medicare Enrollment ID | O20160310000631 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093175804 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Evillo Manuel Domingo |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770587693 PECOS PAC ID: 7719962737 Enrollment ID: I20160310000772 |
Provider Name | Eki O Drake |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063910016 PECOS PAC ID: 8325309305 Enrollment ID: I20190812004116 |
Provider Name | Carlo T Domingo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194251272 PECOS PAC ID: 9537595830 Enrollment ID: I20200205000961 |
Provider Name | Jillian Radecki |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1952018368 PECOS PAC ID: 1052783446 Enrollment ID: I20230213001267 |
Provider Name | Dean Michael Villon Gorospe |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265117204 PECOS PAC ID: 1759742943 Enrollment ID: I20230803004107 |
Provider Name | Jeenu James |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235982893 PECOS PAC ID: 6800236126 Enrollment ID: I20240502002603 |
Provider Name | Sherin Mathew |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730931106 PECOS PAC ID: 1951742626 Enrollment ID: I20240513000782 |
Provider Name | Indu Abraham |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538913942 PECOS PAC ID: 2769823970 Enrollment ID: I20240517002661 |