MEDICARE: K MEDICAL, P.C.

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	332B00000X	Durable Medical Equipment & Medical Supplies	016-004758	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	480032514	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	01608372	OTHER	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699936674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	K MEDICAL, P.C.

Provider Business Mailing Address
First Line	:	7234 W NORTH AVE
Second Line	:	#1712
City	:	ELMWOOD PARK
State	:	IL
Zip	:	60707-4239
Country	:	US
Telephone Number	:	773-895-3668
Fax Number	:	773-764-8650

Provider Business Practice Location Address
First Line	:	4501 W AUGUSTA BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60651-3302
Country	:	US
Telephone Number	:	773-252-4400
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KAREN HUNT
Credential	:	D.P.M.
Telephone Number	:	773-895-3668

Provider Enumeration Date	:	06/23/2008
Last Update Date	:	06/23/2008

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Directions to “K MEDICAL, P.C. ” Practice Location

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