Dr Gabrielle Eileen Mykoniatis, MD | |
20939 S Cicero Ave, Matteson, IL 60443-1620 | |
(708) 679-2770 | |
(708) 283-1137 |
Full Name | Dr Gabrielle Eileen Mykoniatis |
---|---|
Gender | Female |
Speciality | Internal Medicine |
Location | 20939 S Cicero Ave, Matteson, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366461188 | NPI | - | NPPES |
R00340 | Other | IL | MEDICARE PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036119282 (Illinois) | Primary |
Entity Name | Advocate Health And Hospitals Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700824455 PECOS PAC ID: 7810800935 Enrollment ID: O20031106000064 |
Mailing Address | Practice Location Address |
---|---|
Dr Gabrielle Eileen Mykoniatis, MD 20939 S Cicero Ave, Matteson, IL 60443-1620 Ph: (708) 679-2770 | Dr Gabrielle Eileen Mykoniatis, MD 20939 S Cicero Ave, Matteson, IL 60443-1620 Ph: (708) 679-2770 |
Leonard Robinson, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 20939 S Cicero Ave, Matteson, IL 60443 Phone: 708-709-9375 Fax: 708-283-1137 | |
Dorothy M Jones, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 20939 S Cicero Ave, Matteson, IL 60443 Phone: 708-679-2770 Fax: 708-283-1137 | |
Lance T Wallace, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 20939 S Cicero Ave, Matteson, IL 60443 Phone: 708-709-9375 Fax: 708-709-6353 |