| Medintel Pc | |
|
532 Lockard Ln Highwood IL 60040-1223 | |
| (773) 750-9696 | |
| (224) 848-6296 |
| Full Name | Medintel Pc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 532 Lockard Ln, Highwood, Illinois |
| Authorized Official Name and Position | Nelly Kvirikadze (PRESIDENT) |
| Authorized Official Contact | 7737509696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medintel Pc 532 Lockard Ln Highwood IL 60040-1223 Ph: (773) 750-9696 | Medintel Pc 532 Lockard Ln Highwood IL 60040-1223 Ph: (773) 750-9696 |
| NPI Number | 1922414358 |
|---|---|
| Provider Enumeration Date | 07/07/2014 |
| Last Update Date | 07/07/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922414358 | NPI | - | NPPES |
| 036114198 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036114198 (Illinois) | Primary |
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