| Mauricio Junior Miranda, PA-C | |
|
4309 W Medical Center Dr Ste A200, Mchenry, IL 60050-8437 | |
| (815) 759-8070 | |
| (815) 759-4931 |
| Full Name | Mauricio Junior Miranda |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 4309 W Medical Center Dr Ste A200, Mchenry, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982305462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 085009878 (Illinois) | Primary |
| Entity Name | Family Medicine Specialists of Mount Prospect S C |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437389475 PECOS PAC ID: 8224166566 Enrollment ID: O20100507000184 |
| Mailing Address | Practice Location Address |
|---|---|
| Mauricio Junior Miranda, PA-C 4309 W Medical Center Dr Ste A200, Mchenry, IL 60050-8437 Ph: (815) 759-8070 | Mauricio Junior Miranda, PA-C 4309 W Medical Center Dr Ste A200, Mchenry, IL 60050-8437 Ph: (815) 759-8070 |
Nilam M Patel, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4201 W Medical Center Dr, Mchenry, IL 60050 Phone: 815-344-5000 |
Holly Rusch, CSA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4309 W Medical Center Dr Ste B310, Mchenry, IL 60050 Phone: 815-759-4368 Fax: 815-759-4439 |
Nicholas Counterman, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4309 W Medical Center Dr Ste B201, Mchenry, IL 60050 Phone: 847-535-7271 Fax: 847-802-7399 |
Jamie Patel, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4201 W Medical Center Dr, Mchenry, IL 60050 Phone: 815-759-3100 Fax: 815-363-9094 |
Ms. Margaret Sorrells, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4309 W Medical Center Dr Ste B300, Mchenry, IL 60050 Phone: 815-759-4224 Fax: 815-363-0136 |
Justin Duffy, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4309 W Medical Center Dr Ste A200, Mchenry, IL 60050 Phone: 815-759-8070 Fax: 815-759-4931 |
Mr. Edward Timothy Leblanc, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4309 W Medical Center Dr Ste A200, Mchenry, IL 60050 Phone: 815-759-8070 Fax: 815-759-4931 |