| Primary Care Of Illinois, Sc | |
|
1550 N Northwest Hwy Suite 211 Park Ridge IL 60068-1411 | |
| (847) 768-9300 | |
| (847) 768-9393 |
| Full Name | Primary Care Of Illinois, Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1550 N Northwest Hwy, Park Ridge, Illinois |
| Authorized Official Name and Position | Eric J Pales (PRESIDENT/OWNER) |
| Authorized Official Contact | 8477689300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Of Illinois, Sc 1550 N Northwest Hwy Suite 211 Park Ridge IL 60068-1411 Ph: (847) 768-9300 | Primary Care Of Illinois, Sc 1550 N Northwest Hwy Suite 211 Park Ridge IL 60068-1411 Ph: (847) 768-9300 |
| NPI Number | 1114249125 |
|---|---|
| Provider Enumeration Date | 02/17/2010 |
| Last Update Date | 07/07/2015 |
| Medicare PECOS PAC ID | 5597959213 |
|---|---|
| Medicare Enrollment ID | O20101027000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114249125 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Eric Pales |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508938507 PECOS PAC ID: 6103010830 Enrollment ID: I20101027000267 |
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