| Forefront-khatkhate Medical Services Pc | |
|
600 S 2nd St Ste 404 Springfield IL 62704-2542 | |
| (510) 201-0190 | |
| Not Available |
| Full Name | Forefront-khatkhate Medical Services Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 600 S 2nd St Ste 404, Springfield, Illinois |
| Authorized Official Name and Position | Sherry Kovacs (ASSISTANT/PROVIDER ENROLLMENT) |
| Authorized Official Contact | 9495525232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forefront-khatkhate Medical Services Pc 6201 Oak Cyn Ste 150 Irvine CA 92618-5230 Ph: (949) 552-5232 | Forefront-khatkhate Medical Services Pc 600 S 2nd St Ste 404 Springfield IL 62704-2542 Ph: (510) 201-0190 |
| NPI Number | 1164076683 |
|---|---|
| Provider Enumeration Date | 08/01/2019 |
| Last Update Date | 08/10/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164076683 | NPI | - | NPPES |
| 036-119096 | Other | IL | STATE MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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