Common Contracts
1 similar Medicare Private Contract contracts
MEDICARE PRIVATE CONTRACTMedicare Private Contract • July 11th, 2018
This agreement is entered into this day of , by and between Dr. Scott Frank or Dr. Lindsay Powers (hereinafter called “physician”, whose principal medical office is located at 1411 McHenry Rd, Suite 127, Buffalo Grove, IL 60089) and (a patient enrolled in Medicare Part B, hereinafter called “patient”), who resides at _.
