| Kirill Zhadovich, M.d., S.c. | |
|
7900 N Milwaukee Ave Suite 2-24 Niles IL 60714-3159 | |
| (847) 825-0800 | |
| (847) 825-0803 |
| Full Name | Kirill Zhadovich, M.d., S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 7900 N Milwaukee Ave, Niles, Illinois |
| Authorized Official Name and Position | Kirill Zhadovich (PRESIDENT) |
| Authorized Official Contact | 8478250800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kirill Zhadovich, M.d., S.c. Po Box 2056 Northbrook IL 60065-2056 Ph: (847) 825-0800 | Kirill Zhadovich, M.d., S.c. 7900 N Milwaukee Ave Suite 2-24 Niles IL 60714-3159 Ph: (847) 825-0800 |
| NPI Number | 1659556546 |
|---|---|
| Provider Enumeration Date | 01/09/2008 |
| Last Update Date | 03/01/2016 |
| Medicare PECOS PAC ID | 3072545896 |
|---|---|
| Medicare Enrollment ID | O20050901000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659556546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kirill Zhadovich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003881699 PECOS PAC ID: 6608808423 Enrollment ID: I20050907000185 |
| Provider Name | Katarzyna Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356510648 PECOS PAC ID: 4183708282 Enrollment ID: I20080228000133 |
| Provider Name | Mariola Kaczkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861796724 PECOS PAC ID: 3779765243 Enrollment ID: I20110305000041 |
| Provider Name | Alex Kostiv |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639317217 PECOS PAC ID: 4183894157 Enrollment ID: I20110830000494 |
| Provider Name | Shireen Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508278896 PECOS PAC ID: 9133340755 Enrollment ID: I20141024000653 |
| Provider Name | Mary Christine V Deato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992172944 PECOS PAC ID: 9931417383 Enrollment ID: I20151005000663 |
| Provider Name | Katarzyna M Brozek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083103568 PECOS PAC ID: 8224380134 Enrollment ID: I20181003003611 |
| Provider Name | Mary-jennelle Guevara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225397268 PECOS PAC ID: 4789931817 Enrollment ID: I20210104002202 |
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