| Caritas Physicians Group | |
|
140 North Ashland Avenue Chicago IL 60607 | |
| (312) 850-9411 | |
| (312) 850-3288 |
| Full Name | Caritas Physicians Group |
|---|---|
| Speciality | General Practice |
| Location | 140 North Ashland Avenue, Chicago, Illinois |
| Authorized Official Name and Position | Jesseca Watson (CONTRACTS AND CREDENTIALING MANAGER) |
| Authorized Official Contact | 6305728228 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Caritas Physicians Group 1301 West 22nd Street Suite 500 Oak Brook IL 60523 Ph: (630) 572-8228 | Caritas Physicians Group 140 North Ashland Avenue Chicago IL 60607 Ph: (312) 850-9411 |
| NPI Number | 1275004442 |
|---|---|
| Provider Enumeration Date | 12/16/2018 |
| Last Update Date | 10/08/2020 |
| Certification Date | 10/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275004442 | NPI | - | NPPES |
| 0023 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207QA0401X | Family Medicine - Addiction Medicine | () | Secondary |
| 208D00000X | General Practice | () | Primary |
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