| Ameriwound Physicians Il Llc | |
|
4957 Oakton St #306 Skokie IL 60077-2903 | |
| (216) 273-9800 | |
| Not Available |
| Full Name | Ameriwound Physicians Il Llc |
|---|---|
| Speciality | General Practice |
| Location | 4957 Oakton St, Skokie, Illinois |
| Authorized Official Name and Position | Samson Fixler (ASSISTANT SECRETARY) |
| Authorized Official Contact | 2162739800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ameriwound Physicians Il Llc 6150 Parkland Blvd Ste 225 Mayfield Heights OH 44124-4103 Ph: (216) 273-9800 | Ameriwound Physicians Il Llc 4957 Oakton St #306 Skokie IL 60077-2903 Ph: (216) 273-9800 |
| NPI Number | 1104245893 |
|---|---|
| Provider Enumeration Date | 04/10/2014 |
| Last Update Date | 02/08/2023 |
| Medicare PECOS PAC ID | 2860616299 |
|---|---|
| Medicare Enrollment ID | O20140605000079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104245893 | NPI | - | NPPES |
| 1104245893 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Kenneth Pelehac |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487651550 PECOS PAC ID: 1355312679 Enrollment ID: I20040805000599 |
| Provider Name | Rita J Mcguire |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780634733 PECOS PAC ID: 5698748853 Enrollment ID: I20040816001135 |
| Provider Name | Barry M Summers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326117383 PECOS PAC ID: 2163499518 Enrollment ID: I20040914001268 |
| Provider Name | Marconi Deladisma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477597342 PECOS PAC ID: 0648289785 Enrollment ID: I20060418000266 |
| Provider Name | Peter Eric Johnson |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1316146442 PECOS PAC ID: 9638261605 Enrollment ID: I20070822000670 |
| Provider Name | Kevin Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710096557 PECOS PAC ID: 0941399927 Enrollment ID: I20071128000391 |
| Provider Name | Claudia Beals |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992959076 PECOS PAC ID: 2961554761 Enrollment ID: I20090708000567 |
| Provider Name | Richard A Egwele |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306991310 PECOS PAC ID: 2567361389 Enrollment ID: I20120606000395 |
| Provider Name | Nicole A Patino |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1366688913 PECOS PAC ID: 4981854593 Enrollment ID: I20121017000107 |
| Provider Name | Lisa A Moment |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205250859 PECOS PAC ID: 8820220684 Enrollment ID: I20140409000837 |
| Provider Name | Russia Vega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760887152 PECOS PAC ID: 9739401191 Enrollment ID: I20141215000722 |
| Provider Name | Joslyn M Albright |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1790933125 PECOS PAC ID: 7012164296 Enrollment ID: I20150327001229 |
| Provider Name | Harris S Goldenberg |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1700138146 PECOS PAC ID: 0143534438 Enrollment ID: I20150730012638 |
| Provider Name | Carlos L Farias |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1437307337 PECOS PAC ID: 6305996158 Enrollment ID: I20160608000783 |
| Provider Name | Kathleen Elizabeth Detwiler |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1932465259 PECOS PAC ID: 3274837356 Enrollment ID: I20170328001447 |
| Provider Name | Larpie Castro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619491354 PECOS PAC ID: 6002189198 Enrollment ID: I20170912002826 |
| Provider Name | Jingtao Huang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174887020 PECOS PAC ID: 1355640251 Enrollment ID: I20180507002089 |
| Provider Name | Olivia C Castellanos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821551599 PECOS PAC ID: 5597007781 Enrollment ID: I20190509000847 |
| Provider Name | Amy Jo Fugate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962020560 PECOS PAC ID: 8325462484 Enrollment ID: I20200722000688 |
| Provider Name | Magid Keramati |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750584371 PECOS PAC ID: 4880730399 Enrollment ID: I20220504002108 |
| Provider Name | Alban Miller |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1750892923 PECOS PAC ID: 6507290004 Enrollment ID: I20230106000506 |
| Provider Name | Jordan Maxwell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356790851 PECOS PAC ID: 6305134107 Enrollment ID: I20230706003416 |
| Provider Name | Alexandria Adler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568925410 PECOS PAC ID: 5991138323 Enrollment ID: I20230718003575 |
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