| Suburban Neurology | |
|
11 Douglas Ave Ste 253 Elgin IL 60120-5590 | |
| (630) 299-4342 | |
| (630) 405-5857 |
| Full Name | Suburban Neurology |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11 Douglas Ave Ste 253, Elgin, Illinois |
| Authorized Official Name and Position | Subhasree Misra (OWNER) |
| Authorized Official Contact | 7086468352 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suburban Neurology 11 Douglas Ave Ste 253 Elgin IL 60120-5590 Ph: (630) 299-4342 | Suburban Neurology 11 Douglas Ave Ste 253 Elgin IL 60120-5590 Ph: (630) 299-4342 |
| NPI Number | 1043046949 |
|---|---|
| Provider Enumeration Date | 09/09/2024 |
| Last Update Date | 09/18/2024 |
| Certification Date | 09/10/2024 |
| Medicare PECOS PAC ID | 9234660762 |
|---|---|
| Medicare Enrollment ID | O20241008001301 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043046949 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Subhasree Misra |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326092362 PECOS PAC ID: 2365403854 Enrollment ID: I20041019000611 |
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