| Heroes Health Care Inc | |
|
3139 W 111th Street Chicago IL 60655-2205 | |
| (312) 944-4653 | |
| (312) 944-0747 |
| Full Name | Heroes Health Care Inc |
|---|---|
| Speciality | Chiropractor |
| Location | 3139 W 111th Street, Chicago, Illinois |
| Authorized Official Name and Position | Sargon Benjamin Odisho (OWNER) |
| Authorized Official Contact | 7738059517 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heroes Health Care Inc 3139 W 111th Street Chicago IL 60655-2205 Ph: (312) 944-4653 | Heroes Health Care Inc 3139 W 111th Street Chicago IL 60655-2205 Ph: (312) 944-4653 |
| NPI Number | 1932459393 |
|---|---|
| Provider Enumeration Date | 09/13/2012 |
| Last Update Date | 09/14/2015 |
| Medicare PECOS PAC ID | 9931333846 |
|---|---|
| Medicare Enrollment ID | O20131009000082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932459393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (Illinois) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Sargon B Odisho |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1790714061 PECOS PAC ID: 5799785655 Enrollment ID: I20061228000199 |
| Provider Name | John Lombardi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467455139 PECOS PAC ID: 0143127944 Enrollment ID: I20081110000806 |
| Provider Name | Emily Gonzalez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285908558 PECOS PAC ID: 8022319102 Enrollment ID: I20151215000022 |
| Provider Name | Cara Lyn Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497264782 PECOS PAC ID: 5496014169 Enrollment ID: I20180125003178 |
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