| Pmg For Skilled Nursing Llc | |
|
1890 Silver Cross Blvd Ste 350 New Lenox IL 60451-9603 | |
| (815) 717-8737 | |
| (815) 717-8699 |
| Full Name | Pmg For Skilled Nursing Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1890 Silver Cross Blvd Ste 350, New Lenox, Illinois |
| Authorized Official Name and Position | Zafer Jawich (PRESIDENT) |
| Authorized Official Contact | 6308546540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pmg For Skilled Nursing Llc 1890 Silver Cross Blvd Ste 350 New Lenox IL 60451-9603 Ph: (815) 717-8737 | Pmg For Skilled Nursing Llc 1890 Silver Cross Blvd Ste 350 New Lenox IL 60451-9603 Ph: (815) 717-8737 |
| NPI Number | 1861078776 |
|---|---|
| Provider Enumeration Date | 03/22/2021 |
| Last Update Date | 03/22/2021 |
| Medicare PECOS PAC ID | 6103235882 |
|---|---|
| Medicare Enrollment ID | O20210510001560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861078776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Zafer Jawich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326064536 PECOS PAC ID: 6406836105 Enrollment ID: I20040727001028 |
| Provider Name | M Ghaith Mulki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215953369 PECOS PAC ID: 4880610724 Enrollment ID: I20051019000995 |
| Provider Name | Karen J Krooswyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134477706 PECOS PAC ID: 3274760228 Enrollment ID: I20131218001094 |
| Provider Name | Jennifer Alice Nichols |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336745785 PECOS PAC ID: 7416356126 Enrollment ID: I20210601000692 |
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