| Orchard Medical Center Sc | |
|
543 Orchard St Orchard Medical Center Sc Antioch IL 60002-3107 | |
| (847) 395-3322 | |
| (847) 395-0921 |
| Full Name | Orchard Medical Center Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 543 Orchard St, Antioch, Illinois |
| Authorized Official Name and Position | Ashley Matus (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8473953322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orchard Medical Center Sc 543 Orchard St Orchard Medical Center Sc Antioch IL 60002-3107 Ph: (847) 395-3322 | Orchard Medical Center Sc 543 Orchard St Orchard Medical Center Sc Antioch IL 60002-3107 Ph: (847) 395-3322 |
| NPI Number | 1306835491 |
|---|---|
| Provider Enumeration Date | 10/20/2005 |
| Last Update Date | 12/11/2019 |
| Medicare PECOS PAC ID | 9133154610 |
|---|---|
| Medicare Enrollment ID | O20051004000283 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306835491 | NPI | - | NPPES |
| 637760 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Soifer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184843328 PECOS PAC ID: 1557446572 Enrollment ID: I20080314000063 |
| Provider Name | John J Devaney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538152327 PECOS PAC ID: 9830124312 Enrollment ID: I20100213000012 |
| Provider Name | Guy R Abderholden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902899792 PECOS PAC ID: 7012942592 Enrollment ID: I20100213000020 |
| Provider Name | Sophie Huang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386264653 PECOS PAC ID: 5193191708 Enrollment ID: I20221024001828 |
| Provider Name | Raquel Mejos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114516754 PECOS PAC ID: 3375952435 Enrollment ID: I20230717001519 |