MEDICARE: ACE IMMEDIATE CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1346524170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACE IMMEDIATE CARE

Provider Business Mailing Address
First Line	:	8737 DRAKE AVE
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60076-2311
Country	:	US
Telephone Number	:	773-856-0747
Fax Number	:	773-856-0490

Provider Business Practice Location Address
First Line	:	7136 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-2408
Country	:	US
Telephone Number	:	773-856-0747
Fax Number	:	773-856-0490

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	NADEEM MUGHAL
Credential	:	M.D.
Telephone Number	:	773-856-0747

Provider Enumeration Date	:	09/28/2011
Last Update Date	:	09/28/2011

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Directions to “ACE IMMEDIATE CARE ” Practice Location

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