| Mava Healthcare Systems Pllc | |
|
799 Roosevelt Rd Ste 3-03 Glen Ellyn IL 60137-5920 | |
| (708) 356-2400 | |
| (708) 356-2420 |
| Full Name | Mava Healthcare Systems Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 799 Roosevelt Rd Ste 3-03, Glen Ellyn, Illinois |
| Authorized Official Name and Position | Sania Umer (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7083562400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mava Healthcare Systems Pllc 799 Roosevelt Rd Ste 3-03 Glen Ellyn IL 60137-5920 Ph: (708) 356-2400 | Mava Healthcare Systems Pllc 799 Roosevelt Rd Ste 3-03 Glen Ellyn IL 60137-5920 Ph: (708) 356-2400 |
| NPI Number | 1538931902 |
|---|---|
| Provider Enumeration Date | 10/27/2023 |
| Last Update Date | 02/19/2026 |
| Certification Date | 02/19/2026 |
| Medicare PECOS PAC ID | 8921457292 |
|---|---|
| Medicare Enrollment ID | O20231212001600 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538931902 | NPI | - | NPPES |
| Provider Name | Evelyn Ukpolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891198628 PECOS PAC ID: 2466635545 Enrollment ID: I20160308002161 |
| Provider Name | Rachel Amodu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558819219 PECOS PAC ID: 7113396441 Enrollment ID: I20221208002225 |
| Provider Name | Codie Vassar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538690995 PECOS PAC ID: 5496009565 Enrollment ID: I20231112000076 |
| Provider Name | Jawad Riaz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962425280 PECOS PAC ID: 9335185446 Enrollment ID: I20231212001711 |
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