| Jackson Urgent Care PLLC | |
|
1407 E Michigan Ave Jackson MI 49202-3517 | |
| (313) 377-5758 | |
| Not Available |
| Full Name | Jackson Urgent Care PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1407 E Michigan Ave, Jackson, Michigan |
| Authorized Official Name and Position | Ibrahim H Dabaja (DIRECTOR/OWNER) |
| Authorized Official Contact | 5178886348 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Urgent Care PLLC 1407 E Michigan Ave Jackson MI 49202-3517 Ph: (517) 888-6348 | Jackson Urgent Care PLLC 1407 E Michigan Ave Jackson MI 49202-3517 Ph: (313) 377-5758 |
| NPI Number | 1528643723 |
|---|---|
| Provider Enumeration Date | 03/10/2021 |
| Last Update Date | 12/19/2022 |
| Certification Date | 12/19/2022 |
| Medicare PECOS PAC ID | 9234538901 |
|---|---|
| Medicare Enrollment ID | O20210528002120 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528643723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | () | Secondary |
| 261QU0200X | Clinic/center - Urgent Care | () | Primary |
| Provider Name | Ibrahim Dabaja |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053592238 PECOS PAC ID: 5698865921 Enrollment ID: I20071226000247 |
| Provider Name | Lori Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699033548 PECOS PAC ID: 2668625104 Enrollment ID: I20130110000621 |
| Provider Name | Monika a Lewis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699199125 PECOS PAC ID: 2567684756 Enrollment ID: I20141103001336 |
| Provider Name | Danny F Ashkar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417337221 PECOS PAC ID: 1951616432 Enrollment ID: I20150812008053 |
| Provider Name | Fadl a Chokr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003158171 PECOS PAC ID: 5294968350 Enrollment ID: I20160811001131 |
| Provider Name | Wael Hussein Dabaja |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174960371 PECOS PAC ID: 4688977119 Enrollment ID: I20170829003642 |
| Provider Name | Abraham Said Hmeidan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225550312 PECOS PAC ID: 0941560510 Enrollment ID: I20180628001482 |
| Provider Name | Amy Marie Volk |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356980247 PECOS PAC ID: 9638505688 Enrollment ID: I20200211000673 |
| Provider Name | Shelby R Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730812371 PECOS PAC ID: 6305229279 Enrollment ID: I20220810003154 |
| Provider Name | Rifat H Saad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134875388 PECOS PAC ID: 3072983063 Enrollment ID: I20230109002283 |
| Provider Name | Kefah Mazloum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356093553 PECOS PAC ID: 3072988302 Enrollment ID: I20230418002490 |
| Provider Name | Nabeel Omar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306627427 PECOS PAC ID: 1355798869 Enrollment ID: I20231106000724 |
| Provider Name | Vivian Luzier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114774189 PECOS PAC ID: 3173065141 Enrollment ID: I20240605001932 |
| Provider Name | Joshua Dwaine Lentz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134781412 PECOS PAC ID: 6103205679 Enrollment ID: I20250607000069 |
| Provider Name | Margaret Craw |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427874403 PECOS PAC ID: 9133697659 Enrollment ID: I20260504005863 |
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