| Mycare Express Care Inc | |
|
1404 Eastland Dr Ste 103 Bloomington IL 61701-7904 | |
| (309) 319-2393 | |
| Not Available |
| Full Name | Mycare Express Care Inc |
|---|---|
| Speciality | Specialist |
| Location | 1404 Eastland Dr Ste 103, Bloomington, Illinois |
| Authorized Official Name and Position | Jibran Naseer (OWNER) |
| Authorized Official Contact | 3093192393 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mycare Express Care Inc 1404 Eastland Dr Ste 103 Bloomington IL 61701-7904 Ph: (309) 319-2393 | Mycare Express Care Inc 1404 Eastland Dr Ste 103 Bloomington IL 61701-7904 Ph: (309) 319-2393 |
| NPI Number | 1396464657 |
|---|---|
| Provider Enumeration Date | 08/22/2022 |
| Last Update Date | 03/25/2025 |
| Medicare PECOS PAC ID | 3870960172 |
|---|---|
| Medicare Enrollment ID | O20221028002232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396464657 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 174400000X | Specialist | (* (Not Available)) | Primary |
| Provider Name | Jibran Naseer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821261892 PECOS PAC ID: 7012197700 Enrollment ID: I20110803000907 |
| Provider Name | Amber K Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396248464 PECOS PAC ID: 4789947094 Enrollment ID: I20180420000049 |
| Provider Name | Carrie M. Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760972715 PECOS PAC ID: 6507115201 Enrollment ID: I20180814000318 |
| Provider Name | Nasiruddin Khokhar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093459299 PECOS PAC ID: 8022496058 Enrollment ID: I20220603001448 |
| Provider Name | Kaitlyn Renee Heffren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982480638 PECOS PAC ID: 4789036724 Enrollment ID: I20240116001775 |
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