| Generation Vein Clinic LLC | |
|
7800 N Milwaukee Ave Ste 105 Niles IL 60714-3124 | |
| (224) 888-3033 | |
| Not Available |
| Full Name | Generation Vein Clinic LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 7800 N Milwaukee Ave Ste 105, Niles, Illinois |
| Authorized Official Name and Position | Yevgeny Bulbin (CMO) |
| Authorized Official Contact | 8478456465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Generation Vein Clinic LLC 7800 N Milwaukee Ave Ste 105 Niles IL 60714-3124 Ph: (224) 888-3033 | Generation Vein Clinic LLC 7800 N Milwaukee Ave Ste 105 Niles IL 60714-3124 Ph: (224) 888-3033 |
| NPI Number | 1649861451 |
|---|---|
| Provider Enumeration Date | 02/03/2021 |
| Last Update Date | 03/05/2025 |
| Certification Date | 03/05/2025 |
| Medicare PECOS PAC ID | 3375952070 |
|---|---|
| Medicare Enrollment ID | O20210510002622 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649861451 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 2086S0129X | Surgery - Vascular Surgery | () | Secondary |
| Provider Name | Yevgeny Bulbin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437384047 PECOS PAC ID: 1557519345 Enrollment ID: I20210113002929 |
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