Samuel Cube Fernando, MD is a
Internal Medicine physician based in Justice, Illinois. Samuel Cube Fernando is licensed to practice in Illinois (license number ) and his current practice location is 8535 W 79th St, Justice, Illinois. He can be reached at his office (for appointments etc.) via phone at
(708) 458-7474.
NPI number for Samuel Cube Fernando is 1023124930 and his current mailing address is 8535 W 79th St, Justice, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1023124930.
Physician's Profile
| Full Name | Samuel Cube Fernando |
|---|
| Gender | Male |
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| Speciality | Internal Medicine |
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| Location | 8535 W 79th St, Justice, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1023124930
- Provider Enumeration Date: 08/22/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Samuel Cube Fernando such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1023124930 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel Cube Fernando is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Samuel Cube Fernando, MD
8535 W 79th St,
Justice, IL 60458-2281
Ph: (708) 458-7474 | Samuel Cube Fernando, MD
8535 W 79th St,
Justice, IL 60458-2281
Ph: (708) 458-7474 |
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