| Greenleaf Medical Associates S.c. | |
|
401 Greenleaf Ave 1 Park City IL 60085-5744 | |
| (847) 662-0978 | |
| (847) 662-1395 |
| Full Name | Greenleaf Medical Associates S.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 401 Greenleaf Ave, Park City, Illinois |
| Authorized Official Name and Position | Joe Anthony (ADMINISTRATOR) |
| Authorized Official Contact | 8476620977 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenleaf Medical Associates S.c. 401 Greenleaf Ave 1 Park City IL 60085-5744 Ph: (847) 662-0978 | Greenleaf Medical Associates S.c. 401 Greenleaf Ave 1 Park City IL 60085-5744 Ph: (847) 662-0978 |
| NPI Number | 1447310479 |
|---|---|
| Provider Enumeration Date | 12/11/2006 |
| Last Update Date | 12/19/2024 |
| Medicare PECOS PAC ID | 3870491277 |
|---|---|
| Medicare Enrollment ID | O20031223000099 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447310479 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Illinois) | Primary |
| Provider Name | Peter Joseph Puthenveetil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538268230 PECOS PAC ID: 5092613406 Enrollment ID: I20031223000141 |
Kokila Avasthi Dds Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 S Greenleaf Ave, Ste #3, Park City, IL 60085 Phone: 847-662-8341 |