| Longevity Accountable Care, PA | |
|
6300 N California Ave Chicago IL 60659-1702 | |
| (773) 973-1900 | |
| Not Available |
| Full Name | Longevity Accountable Care, PA |
|---|---|
| Speciality | Family Medicine |
| Location | 6300 N California Ave, Chicago, Illinois |
| Authorized Official Name and Position | Diane Vincur (PRACTICE MANAGER) |
| Authorized Official Contact | 5618152427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Accountable Care, PA 11780 Us Highway 1 Ste N107 North Palm Beach FL 33408-3007 Ph: (561) 815-2427 | Longevity Accountable Care, PA 6300 N California Ave Chicago IL 60659-1702 Ph: (773) 973-1900 |
| NPI Number | 1144078965 |
|---|---|
| Provider Enumeration Date | 05/07/2024 |
| Last Update Date | 05/07/2024 |
| Certification Date | 05/07/2024 |
| Medicare PECOS PAC ID | 0840734034 |
|---|---|
| Medicare Enrollment ID | O20240717003454 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144078965 | NPI | - | NPPES |
| Provider Name | Rachel Muthui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831473040 PECOS PAC ID: 9537328968 Enrollment ID: I20120305000423 |
| Provider Name | Sara Acosta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831548478 PECOS PAC ID: 2365732997 Enrollment ID: I20160609001101 |
| Provider Name | Maria P Sayi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497203434 PECOS PAC ID: 1658668926 Enrollment ID: I20160930000009 |
| Provider Name | Tricia Muir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003347592 PECOS PAC ID: 6305122854 Enrollment ID: I20170417001904 |
| Provider Name | Roshini James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760938120 PECOS PAC ID: 8729365457 Enrollment ID: I20170508001115 |
| Provider Name | Habiba P Bracero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598255689 PECOS PAC ID: 8921354978 Enrollment ID: I20180703003240 |
| Provider Name | Mary Jeane R Velez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073084497 PECOS PAC ID: 5294073672 Enrollment ID: I20190211000026 |
| Provider Name | Nikita Sarath Gummadi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770057440 PECOS PAC ID: 8729326954 Enrollment ID: I20190214000917 |
| Provider Name | Melissa Nancy Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740830777 PECOS PAC ID: 7810325214 Enrollment ID: I20200318001624 |
| Provider Name | Krutikaben V Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861013823 PECOS PAC ID: 7113343765 Enrollment ID: I20200813002224 |
| Provider Name | Basirat Sulaiman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447851472 PECOS PAC ID: 5193133585 Enrollment ID: I20210423002025 |
| Provider Name | Viktoriya Rouse-freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932747078 PECOS PAC ID: 8729479944 Enrollment ID: I20211223001506 |
| Provider Name | Adejimi Carrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235887779 PECOS PAC ID: 9032506340 Enrollment ID: I20220504002416 |
| Provider Name | Jean Alcasid Yao |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639813751 PECOS PAC ID: 4587041405 Enrollment ID: I20220516001453 |
| Provider Name | Nimmy Merin Baby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508502980 PECOS PAC ID: 3476932682 Enrollment ID: I20220617002194 |
| Provider Name | Sheila Eyah Lambi - Oben |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134549942 PECOS PAC ID: 6406959477 Enrollment ID: I20240718000932 |
| Provider Name | Ancy Pappan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811508799 PECOS PAC ID: 4789086927 Enrollment ID: I20241111002258 |
| Provider Name | Artricia Bonaparte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114413804 PECOS PAC ID: 2668720285 Enrollment ID: I20250305001713 |
| Provider Name | Michele Junious Lyons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114560539 PECOS PAC ID: 9234490376 Enrollment ID: I20260224000768 |
| Provider Name | Olukemi M Adeleke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952804361 PECOS PAC ID: 0749528446 Enrollment ID: I20260226001348 |
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