| Geriatric Professional Services Sc | |
|
109 N 129th Infantry Dr Joliet IL 60435-5135 | |
| (800) 353-4980 | |
| (800) 356-2390 |
| Full Name | Geriatric Professional Services Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 109 N 129th Infantry Dr, Joliet, Illinois |
| Authorized Official Name and Position | Karim Tourk (PRESIDENT) |
| Authorized Official Contact | 8156712303 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Geriatric Professional Services Sc 109 N 129th Infantry Dr Joliet IL 60435-5135 Ph: (800) 353-4980 | Geriatric Professional Services Sc 109 N 129th Infantry Dr Joliet IL 60435-5135 Ph: (800) 353-4980 |
| NPI Number | 1811266315 |
|---|---|
| Provider Enumeration Date | 12/29/2011 |
| Last Update Date | 11/27/2023 |
| Medicare PECOS PAC ID | 6103086434 |
|---|---|
| Medicare Enrollment ID | O20120323000592 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811266315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036102125 (Illinois) | Primary |
| Provider Name | Karim K Tourk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679569347 PECOS PAC ID: 0941338685 Enrollment ID: I20100517000681 |
| Provider Name | Danielle K Pagano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760891766 PECOS PAC ID: 5395965016 Enrollment ID: I20141001001041 |
| Provider Name | Amanda Susanne Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801341136 PECOS PAC ID: 3173810355 Enrollment ID: I20161003002128 |
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