| Provida Family Medicine | |
|
1425 N Hunt Club Rd Ste 100 Gurnee IL 60031 | |
| (847) 548-2200 | |
| (847) 548-2865 |
| Full Name | Provida Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1425 N Hunt Club Rd Ste 100, Gurnee, Illinois |
| Authorized Official Name and Position | Luis I Salazar (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8475482200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Provida Family Medicine 1425 N Hunt Club Rd Ste 100 Gurnee IL 60031-2632 Ph: (847) 548-2200 | Provida Family Medicine 1425 N Hunt Club Rd Ste 100 Gurnee IL 60031 Ph: (847) 548-2200 |
| NPI Number | 1881890333 |
|---|---|
| Provider Enumeration Date | 06/22/2007 |
| Last Update Date | 01/31/2024 |
| Medicare PECOS PAC ID | 1557386273 |
|---|---|
| Medicare Enrollment ID | O20051012000360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881890333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 042616958 (Illinois) | Primary |
| Provider Name | Luis I Salazar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417942822 PECOS PAC ID: 1355366071 Enrollment ID: I20051017000009 |
| Provider Name | Monica H Gonzalez |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1902197155 PECOS PAC ID: 0749451599 Enrollment ID: I20110927000633 |
| Provider Name | Caitlin M Chandran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821404336 PECOS PAC ID: 0042432783 Enrollment ID: I20141112001304 |
| Provider Name | Peter J Nani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437688579 PECOS PAC ID: 7810257615 Enrollment ID: I20210302000709 |
| Provider Name | Susie Annette Gonzalez-lazarevic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245847656 PECOS PAC ID: 9537575279 Enrollment ID: I20210304001369 |
| Provider Name | Jessie L. Dinelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487343729 PECOS PAC ID: 1850752940 Enrollment ID: I20230807000105 |
| Provider Name | Elida Gricelda Trejo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811777683 PECOS PAC ID: 3779935010 Enrollment ID: I20240123000396 |
| Provider Name | Alejandra Camacho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891568531 PECOS PAC ID: 9537502752 Enrollment ID: I20240205002899 |
M P M Family Health Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1445 N Hunt Club Rd, Suite 304, Gurnee, IL 60031 Phone: 847-383-5428 | |
Hosep H Deyrmenjian, Md, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6440 Grand Ave, Suite 205, Gurnee, IL 60031 Phone: 847-855-3150 Fax: 847-855-3143 | |
Wai Chee Cheung-o'carroll, M.d., S.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1445 N Hunt Club Rd, Suite 304, Gurnee, IL 60031 Phone: 847-855-0100 Fax: 847-855-0101 | |
Paru K Sharma Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7505 Grand Ave, Gurnee, IL 60031 Phone: 847-245-8448 Fax: 847-245-7070 | |
Chicago Medical Clinic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 S Greenleaf St, Suite A, Gurnee, IL 60031 Phone: 847-596-4521 | |
Gurnee Stone Medical Center P.c Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7505 Grand Ave, Gurnee, IL 60031 Phone: 847-856-7615 | |
Lake Shore Gastroenterolgy Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 Tower Ct, Suite C, Gurnee, IL 60031 Phone: 847-244-6320 Fax: 847-244-5095 |