| Angel Medical Center Ltd | |
|
2619 S Lawndale Ave R Suite Chicago IL 60623-4520 | |
| (773) 521-4305 | |
| Not Available |
| Full Name | Angel Medical Center Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 2619 S Lawndale Ave, Chicago, Illinois |
| Authorized Official Name and Position | Juan Carlos Villamizar-zuniga (PRESIDENT) |
| Authorized Official Contact | 7735214305 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Medical Center Ltd 2619 S Lawndale Ave R Suite Chicago IL 60623-4520 Ph: (773) 521-4305 | Angel Medical Center Ltd 2619 S Lawndale Ave R Suite Chicago IL 60623-4520 Ph: (773) 521-4305 |
| NPI Number | 1720279532 |
|---|---|
| Provider Enumeration Date | 08/06/2007 |
| Last Update Date | 08/06/2007 |
| Medicare PECOS PAC ID | 7315031770 |
|---|---|
| Medicare Enrollment ID | O20070917000529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720279532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| Provider Name | Juan C Villamizar-zuniga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326133711 PECOS PAC ID: 9931199973 Enrollment ID: I20040513000301 |
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