| Mso Illinois Llc | |
|
6400 W College Dr Ste 100 Palos Heights IL 60463-1789 | |
| (253) 335-5150 | |
| (253) 984-1079 |
| Full Name | Mso Illinois Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6400 W College Dr Ste 100, Palos Heights, Illinois |
| Authorized Official Name and Position | Muahmmad Nazir (OWNER) |
| Authorized Official Contact | 2533355150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mso Illinois Llc 6400 W College Dr Ste 100 Palos Heights IL 60463-1789 Ph: (253) 335-5150 | Mso Illinois Llc 6400 W College Dr Ste 100 Palos Heights IL 60463-1789 Ph: (253) 335-5150 |
| NPI Number | 1568209880 |
|---|---|
| Provider Enumeration Date | 07/12/2024 |
| Last Update Date | 07/12/2024 |
| Medicare PECOS PAC ID | 2961930581 |
|---|---|
| Medicare Enrollment ID | O20250110000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568209880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Yesenia Bahena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194165118 PECOS PAC ID: 6709166549 Enrollment ID: I20161213001111 |
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