| The Center For Primary Care & Sports Medicine | |
|
3965 75th St Suite 103 Aurora IL 60504-7925 | |
| (630) 375-1625 | |
| (630) 375-1925 |
| Full Name | The Center For Primary Care & Sports Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 3965 75th St, Aurora, Illinois |
| Authorized Official Name and Position | Margaret M Cooley (OFFICE MANAGER) |
| Authorized Official Contact | 6303751625 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Center For Primary Care & Sports Medicine 3965 75th St Suite 103 Aurora IL 60504-7925 Ph: (630) 375-1625 | The Center For Primary Care & Sports Medicine 3965 75th St Suite 103 Aurora IL 60504-7925 Ph: (630) 375-1625 |
| NPI Number | 1235225269 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 07/23/2008 |
| Medicare PECOS PAC ID | 3173695079 |
|---|---|
| Medicare Enrollment ID | O20080710000074 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235225269 | NPI | - | NPPES |
| 0005442619 | Other | IL | AETNA |
| 02232125 | Other | IL | BLUE CROSS BLUE SHIELD ILLINOIS |
| 036091557 | Medicaid | IL | |
| 1767232 | Other | IL | UNITED HEALTHCARE |
| 1903680 | Other | IL | CIGNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Lawrence T Kacmar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699861682 PECOS PAC ID: 4183796089 Enrollment ID: I20080710000065 |
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