| Master Medical Care Llc | |
|
10 Emerald Ter Swansea IL 62226-2310 | |
| (618) 235-6780 | |
| (618) 235-6740 |
| Full Name | Master Medical Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10 Emerald Ter, Swansea, Illinois |
| Authorized Official Name and Position | Khaja Mohsin (OWNER) |
| Authorized Official Contact | 6183972750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Master Medical Care Llc 10 Emerald Ter Swansea IL 62226-2310 Ph: (618) 235-6780 | Master Medical Care Llc 10 Emerald Ter Swansea IL 62226-2310 Ph: (618) 235-6780 |
| NPI Number | 1184679466 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 02/06/2012 |
| Medicare PECOS PAC ID | 6709830227 |
|---|---|
| Medicare Enrollment ID | O20050308000947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184679466 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036112195 (Illinois) | Primary |
| Provider Name | Khaja G Mohsin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730162108 PECOS PAC ID: 1951362300 Enrollment ID: I20041020000317 |
| Provider Name | Richard Stephen Vogt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811258593 PECOS PAC ID: 4082864640 Enrollment ID: I20121017000689 |
| Provider Name | Michael Kevin Lemp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063839504 PECOS PAC ID: 1052537487 Enrollment ID: I20140721002413 |
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