| Elena Fitchev Md Ltd | |
|
800 Austin St Ste 502w Evanston IL 60202-3445 | |
| (847) 328-3213 | |
| Not Available |
| Full Name | Elena Fitchev Md Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 800 Austin St Ste 502w, Evanston, Illinois |
| Authorized Official Name and Position | Elena Fitchev (OWNER) |
| Authorized Official Contact | 8473283213 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elena Fitchev Md Ltd 800 Austin St Ste 502w Evanston IL 60202-3445 Ph: (847) 328-3213 | Elena Fitchev Md Ltd 800 Austin St Ste 502w Evanston IL 60202-3445 Ph: (847) 328-3213 |
| NPI Number | 1912122383 |
|---|---|
| Provider Enumeration Date | 04/13/2007 |
| Last Update Date | 02/27/2018 |
| Medicare PECOS PAC ID | 7618073693 |
|---|---|
| Medicare Enrollment ID | O20070508000553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912122383 | NPI | - | NPPES |
| 036092221 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036092221 (Illinois) | Primary |
| Provider Name | Elena I Fitchev |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982779047 PECOS PAC ID: 9234235219 Enrollment ID: I20070508000594 |
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