| Lake Immediate Care & Clinic S C | |
|
452 W State Rd Ste D Island Lake IL 60042-8438 | |
| (847) 519-1061 | |
| Not Available |
| Full Name | Lake Immediate Care & Clinic S C |
|---|---|
| Speciality | Internal Medicine |
| Location | 452 W State Rd Ste D, Island Lake, Illinois |
| Authorized Official Name and Position | Eberechukwu Ibe (PRESIDENT) |
| Authorized Official Contact | 7086067219 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Immediate Care & Clinic S C 452 W State Rd Ste D Island Lake IL 60042-8438 Ph: (847) 519-1061 | Lake Immediate Care & Clinic S C 452 W State Rd Ste D Island Lake IL 60042-8438 Ph: (847) 519-1061 |
| NPI Number | 1114208642 |
|---|---|
| Provider Enumeration Date | 08/29/2011 |
| Last Update Date | 10/27/2011 |
| Medicare PECOS PAC ID | 4183881899 |
|---|---|
| Medicare Enrollment ID | O20120208000699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114208642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036113328 (Illinois) | Secondary |
| 207R00000X | Internal Medicine | 036107391 (Illinois) | Primary |
| Provider Name | Eberechukwu O Ibe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841258043 PECOS PAC ID: 5395648406 Enrollment ID: I20040128000176 |
| Provider Name | Reginald A Ebirim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396702957 PECOS PAC ID: 6406889690 Enrollment ID: I20050917000240 |
Gurbax Singh Saini Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 27979 N Converse Rd, Island Lake, IL 60042 Phone: 847-526-8830 Fax: 847-526-8985 |