| Coralis Health, Llc | |
|
4 Walker Ave Ste B Clarendon Hills IL 60514-1351 | |
| (708) 722-6218 | |
| Not Available |
| Full Name | Coralis Health, Llc |
|---|---|
| Speciality | Pediatrics |
| Location | 4 Walker Ave Ste B, Clarendon Hills, Illinois |
| Authorized Official Name and Position | Angelica Robles (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 9808908668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coralis Health, Llc 47 W Division St Ste 360 Chicago IL 60610-2419 Ph: (708) 722-6061 | Coralis Health, Llc 4 Walker Ave Ste B Clarendon Hills IL 60514-1351 Ph: (708) 722-6218 |
| NPI Number | 1891574927 |
|---|---|
| Provider Enumeration Date | 09/27/2023 |
| Last Update Date | 11/13/2024 |
| Medicare PECOS PAC ID | 7911341979 |
|---|---|
| Medicare Enrollment ID | O20240216004423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891574927 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 2080P0006X | Pediatrics - Developmental - Behavioral Pediatrics | (* (Not Available)) | Primary |
| Provider Name | Angelica Victoria Robles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609132059 PECOS PAC ID: 4587909452 Enrollment ID: I20240216004451 |
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