Provider Demographics
NPI:1497428312
Name:MIDWEST POST ACUTE CARE OF CALIFORNIA ACO PC
Entity Type:Organization
Organization Name:MIDWEST POST ACUTE CARE OF CALIFORNIA ACO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNONE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:888-660-4425
Mailing Address - Street 1:2045 W GRAND AVE STE B28354
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-1576
Mailing Address - Country:US
Mailing Address - Phone:888-705-8722
Mailing Address - Fax:888-705-8722
Practice Address - Street 1:200 N LA SALLE ST STE 1550
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-1034
Practice Address - Country:US
Practice Address - Phone:888-705-8722
Practice Address - Fax:888-705-8722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty