| Medical Center Of Dyer, Ltd | |
|
11164 Southwest Hwy Palos Hills IL 60465-2709 | |
| (708) 907-3422 | |
| (708) 249-6775 |
| Full Name | Medical Center Of Dyer, Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 11164 Southwest Hwy, Palos Hills, Illinois |
| Authorized Official Name and Position | Ameira Khaleq (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 7086551489 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Center Of Dyer, Ltd 11164 Southwest Hwy Palos Hills IL 60465-2709 Ph: (708) 907-3422 | Medical Center Of Dyer, Ltd 11164 Southwest Hwy Palos Hills IL 60465-2709 Ph: (708) 907-3422 |
| NPI Number | 1902173826 |
|---|---|
| Provider Enumeration Date | 11/21/2011 |
| Last Update Date | 06/01/2023 |
| Medicare PECOS PAC ID | 3274700190 |
|---|---|
| Medicare Enrollment ID | O20140123000491 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902173826 | NPI | - | NPPES |
| 1891769303 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ossama Zorub |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891769303 PECOS PAC ID: 4789699612 Enrollment ID: I20061020000100 |
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