| Premiumhealthcare Pc | |
|
3800 Highland Ave Ste 111 Downers Grove IL 60515-1558 | |
| (815) 280-5796 | |
| Not Available |
| Full Name | Premiumhealthcare Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3800 Highland Ave Ste 111, Downers Grove, Illinois |
| Authorized Official Name and Position | Jose F Rivera Guerrero (OWNER) |
| Authorized Official Contact | 9175431967 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premiumhealthcare Pc 3800 Highland Ave Ste 111 Downers Grove IL 60515-1558 Ph: (815) 280-5796 | Premiumhealthcare Pc 3800 Highland Ave Ste 111 Downers Grove IL 60515-1558 Ph: (815) 280-5796 |
| NPI Number | 1386184448 |
|---|---|
| Provider Enumeration Date | 03/08/2017 |
| Last Update Date | 02/27/2023 |
| Medicare PECOS PAC ID | 8224315239 |
|---|---|
| Medicare Enrollment ID | O20170501000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386184448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MD2011-0111 (New Mexico) | Primary |
| Provider Name | Jose F Rivera Guerrero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316190028 PECOS PAC ID: 5597935874 Enrollment ID: I20170426001894 |
| Provider Name | Cristina A Perez Gomez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568718526 PECOS PAC ID: 3375794928 Enrollment ID: I20170501000401 |
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