| Skyline Healthcare | |
|
8712 N Olcott Ave Niles IL 60714-2024 | |
| (708) 942-4785 | |
| Not Available |
| Full Name | Skyline Healthcare |
|---|---|
| Speciality | Internal Medicine |
| Location | 8712 N Olcott Ave, Niles, Illinois |
| Authorized Official Name and Position | Sufyan Abdulmujeeb (OWNER) |
| Authorized Official Contact | 7089424785 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Skyline Healthcare 8712 N Olcott Ave Niles IL 60714-2024 Ph: (708) 942-4785 | Skyline Healthcare 8712 N Olcott Ave Niles IL 60714-2024 Ph: (708) 942-4785 |
| NPI Number | 1972324200 |
|---|---|
| Provider Enumeration Date | 10/19/2024 |
| Last Update Date | 10/19/2024 |
| Medicare PECOS PAC ID | 7517493455 |
|---|---|
| Medicare Enrollment ID | O20241216001304 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972324200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sufyan M Abdulmujeeb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013478452 PECOS PAC ID: 2163808171 Enrollment ID: I20220928002710 |
| Provider Name | Teddy Enoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114484185 PECOS PAC ID: 7315474350 Enrollment ID: I20250102002380 |
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