MEDICARE: GOLF MILL FAMILY CLINIC

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	208D00000X	General Practice Physician	036088851	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891954707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLF MILL FAMILY CLINIC

Provider Business Mailing Address
First Line	:	8937 W GOLF RD
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-5812
Country	:	US
Telephone Number	:	847-975-9711
Fax Number	:

Provider Business Practice Location Address
First Line	:	8937 W GOLF RD
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-5812
Country	:	US
Telephone Number	:	847-975-9711
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BELLA ZARUBINSKY
Credential	:	MD
Telephone Number	:	847-375-9711

Provider Enumeration Date	:	06/05/2008
Last Update Date	:	01/18/2011

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Directions to “GOLF MILL FAMILY CLINIC ” Practice Location

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