| Icon Clinic Llc | |
|
2000 Rhode Island Ave Ne Washington DC 20018-2835 | |
| (240) 455-3166 | |
| (240) 455-4154 |
| Full Name | Icon Clinic Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2000 Rhode Island Ave Ne, Washington, District Of Columbia |
| Authorized Official Name and Position | Thickness Patrick Egwuatu (PROVIDER/CEO) |
| Authorized Official Contact | 2022887752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Icon Clinic Llc 7735 Belle Point Dr Greenbelt MD 20770-3300 Ph: (240) 455-3166 | Icon Clinic Llc 2000 Rhode Island Ave Ne Washington DC 20018-2835 Ph: (240) 455-3166 |
| NPI Number | 1245808666 |
|---|---|
| Provider Enumeration Date | 06/13/2021 |
| Last Update Date | 09/08/2025 |
| Certification Date | 09/08/2025 |
| Medicare PECOS PAC ID | 7719383967 |
|---|---|
| Medicare Enrollment ID | O20210914000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245808666 | NPI | - | NPPES |
| Provider Name | Thickness Patrick Egwuatu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053997122 PECOS PAC ID: 8628474871 Enrollment ID: I20210914000371 |
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