| Garcia Medical Center | |
|
3538 W Fullerton Ave Chicago IL 60647-2443 | |
| (773) 772-1212 | |
| (773) 772-8666 |
| Full Name | Garcia Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 3538 W Fullerton Ave, Chicago, Illinois |
| Authorized Official Name and Position | Ramon Andres Garcia (PRESIDENT) |
| Authorized Official Contact | 7737721212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Garcia Medical Center 3538 W Fullerton Ave Chicago IL 60647-2443 Ph: (773) 772-1212 | Garcia Medical Center 3538 W Fullerton Ave Chicago IL 60647-2443 Ph: (773) 772-1212 |
| NPI Number | 1124178330 |
|---|---|
| Provider Enumeration Date | 01/11/2007 |
| Last Update Date | 02/22/2011 |
| Medicare PECOS PAC ID | 9335183243 |
|---|---|
| Medicare Enrollment ID | O20050613000284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124178330 | NPI | - | NPPES |
| 042006331 | Other | IL | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 042 006331 (Illinois) | Primary |
| Provider Name | Evelyn Diaz-jimenez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043380231 PECOS PAC ID: 8820986532 Enrollment ID: I20040305000142 |
| Provider Name | Jose Castellanos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750302386 PECOS PAC ID: 6608816756 Enrollment ID: I20050509000050 |
| Provider Name | Javier Flores |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164445854 PECOS PAC ID: 7517964414 Enrollment ID: I20061108000108 |
| Provider Name | Ramon A Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235295999 PECOS PAC ID: 0244274165 Enrollment ID: I20090210000449 |
| Provider Name | Ricardo Machado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700879434 PECOS PAC ID: 5294885935 Enrollment ID: I20090618000102 |
| Provider Name | Thomas P Poepping |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306824727 PECOS PAC ID: 4587856919 Enrollment ID: I20101004001264 |
| Provider Name | Jose A Lusancarez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609180249 PECOS PAC ID: 9436345139 Enrollment ID: I20201111000631 |
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