| Chicagoland Wellmed Center Sc | |
|
11933 S Pulaski Rd Ste C1 Alsip IL 60803-1100 | |
| (708) 396-2500 | |
| Not Available |
| Full Name | Chicagoland Wellmed Center Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11933 S Pulaski Rd Ste C1, Alsip, Illinois |
| Authorized Official Name and Position | Frank Vaught (OWNER) |
| Authorized Official Contact | 3147045959 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicagoland Wellmed Center Sc 4071 Teak Cir Naperville IL 60564-1104 Ph: (314) 704-5959 | Chicagoland Wellmed Center Sc 11933 S Pulaski Rd Ste C1 Alsip IL 60803-1100 Ph: (708) 396-2500 |
| NPI Number | 1881334373 |
|---|---|
| Provider Enumeration Date | 03/31/2022 |
| Last Update Date | 03/31/2022 |
| Medicare PECOS PAC ID | 6507239431 |
|---|---|
| Medicare Enrollment ID | O20230223002985 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881334373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Frank A Vaught |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1174544316 PECOS PAC ID: 6507828738 Enrollment ID: I20041101000109 |
| Provider Name | Syed Ahmed Naseeruddin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760599575 PECOS PAC ID: 4981754017 Enrollment ID: I20110808000747 |
| Provider Name | Monica Conway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699425066 PECOS PAC ID: 6305217902 Enrollment ID: I20230118001909 |
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