| Gregory Kaczmarek, Md, Llc | |
|
4905 Old Orchard Ctr Lower Level Skokie IL 60077-1458 | |
| (847) 679-6707 | |
| Not Available |
| Full Name | Gregory Kaczmarek, Md, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4905 Old Orchard Ctr, Skokie, Illinois |
| Authorized Official Name and Position | Gregory D Kaczmarek (PRESIDENT) |
| Authorized Official Contact | 8476796707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory Kaczmarek, Md, Llc 4905 Old Orchard Ctr Lower Level Skokie IL 60077-1458 Ph: (847) 679-6707 | Gregory Kaczmarek, Md, Llc 4905 Old Orchard Ctr Lower Level Skokie IL 60077-1458 Ph: (847) 679-6707 |
| NPI Number | 1780925305 |
|---|---|
| Provider Enumeration Date | 03/06/2013 |
| Last Update Date | 03/06/2013 |
| Medicare PECOS PAC ID | 8729212857 |
|---|---|
| Medicare Enrollment ID | O20131003000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780925305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036081697 (Illinois) | Primary |
| Provider Name | Gregory D Kaczmarek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629032958 PECOS PAC ID: 7315941283 Enrollment ID: I20060907000295 |
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