| Lake Street Family Medicine, Llc | |
|
220 E Lake St Suite 100 Addison IL 60101-2887 | |
| (630) 516-0434 | |
| (630) 516-0419 |
| Full Name | Lake Street Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 220 E Lake St, Addison, Illinois |
| Authorized Official Name and Position | Brian Koecher (PHYSICIAN) |
| Authorized Official Contact | 6305160434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Street Family Medicine, Llc 220 E Lake St Suite 100 Addison IL 60101-2887 Ph: (630) 516-0434 | Lake Street Family Medicine, Llc 220 E Lake St Suite 100 Addison IL 60101-2887 Ph: (630) 516-0434 |
| NPI Number | 1639204613 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 12/11/2012 |
| Medicare PECOS PAC ID | 3072530237 |
|---|---|
| Medicare Enrollment ID | O20051027000025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639204613 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ekta Ohri |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043301773 PECOS PAC ID: 0749227304 Enrollment ID: I20050414000732 |
| Provider Name | Brian Steven Koecher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134210834 PECOS PAC ID: 7618994872 Enrollment ID: I20051028000256 |
Medical Square Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 276 W Fullerton Ave, Addison, IL 60101 Phone: 630-543-5454 Fax: 630-543-5471 | |
Access Community Health Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1111 W Lake St, Addison, IL 60101 Phone: 773-257-6770 | |
Concentra Urgent Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 South Grace Street, Addison, IL 60101 Phone: 630-543-4040 Fax: 630-543-1050 | |
Ricardo Martinez, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1201 W Army Trail Blvd, Addison, IL 60101 Phone: 630-458-9200 Fax: 630-458-8460 | |
Concentra Medical Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 501 S Grace St, Addison, IL 60101 Phone: 630-543-4040 Fax: 630-543-1050 | |
Bozena Scigacz Medical Office S.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 28 W Lake St, Suite 2, Addison, IL 60101 Phone: 630-458-0688 Fax: 630-458-0698 | |
Primary Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 W Lake St, Suite 206, Addison, IL 60101 Phone: 630-543-4200 |