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NPI Code Detail

MEDICARE: CIRCLE FAMILY CARE

MEDICARE: CIRCLE FAMILY 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
1207Q00000XFamily Medicine PhysicianIL

General Provider Information

NPI Number : 1386707743
Entity Type Code : Organization
Provider Name (Legal Business Name) : CIRCLE FAMILY CARE
Provider Business Mailing Address
First Line : 5002 W MADISON
Second Line :
City : CHICAGO
State : IL
Zip : 60644-4127
Country : US
Telephone Number : 773-379-1000
Fax Number : 773-379-1342
Provider Business Practice Location Address
First Line : 5120 W JACKSON
Second Line :
City : CHICAGO
State : IL
Zip : 60644-4332
Country : US
Telephone Number : 773-378-3900
Fax Number : 773-378-2602
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : MR. REUBEN J PETTIFORD
Credential :
Telephone Number : 773-379-1000
Provider Enumeration Date : 12/18/2006
Last Update Date : 07/21/2022

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Directions to “CIRCLE FAMILY CARE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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