| Family Health Care Of Cissna Park | |
|
510 Prairie Ln Unit B Cissna Park IL 60924-9710 | |
| (815) 457-2000 | |
| (815) 457-2015 |
| Full Name | Family Health Care Of Cissna Park |
|---|---|
| Speciality | Clinic/Center |
| Location | 510 Prairie Ln Unit B, Cissna Park, Illinois |
| Authorized Official Name and Position | Matthew Ertel (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2177842601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health Care Of Cissna Park 510 Prairie Ln Unit B Cissna Park IL 60924-9710 Ph: (815) 457-2000 | Family Health Care Of Cissna Park 510 Prairie Ln Unit B Cissna Park IL 60924-9710 Ph: (815) 457-2000 |
| NPI Number | 1356884993 |
|---|---|
| Provider Enumeration Date | 11/30/2016 |
| Last Update Date | 02/04/2022 |
| Medicare PECOS PAC ID | 5092703124 |
|---|---|
| Medicare Enrollment ID | O20170111000757 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356884993 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Cissna Park Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 141 W. Garfield Ave, Cissna Park, IL 60924 Phone: 217-283-5531 Fax: 217-283-7981 |