| Advanced Family Clinic Ltd | |
|
2246 W Chicago Ave Chicago IL 60622-4827 | |
| (773) 276-6831 | |
| (773) 276-9394 |
| Full Name | Advanced Family Clinic Ltd |
|---|---|
| Speciality | General Practice |
| Location | 2246 W Chicago Ave, Chicago, Illinois |
| Authorized Official Name and Position | Halyna Boryslavska (PRESIDENT) |
| Authorized Official Contact | 7732766831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Family Clinic Ltd 2246 W Chicago Ave Chicago IL 60622-4827 Ph: (773) 276-6831 | Advanced Family Clinic Ltd 2246 W Chicago Ave Chicago IL 60622-4827 Ph: (773) 276-6831 |
| NPI Number | 1093977175 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 06/30/2008 |
| Medicare PECOS PAC ID | 3971671157 |
|---|---|
| Medicare Enrollment ID | O20081001000786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093977175 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 036119204 (Illinois) | Primary |
| Provider Name | Halyna Boryslavska |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992966014 PECOS PAC ID: 5890863070 Enrollment ID: I20081001000779 |
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