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2540 Hauser-ross Drive Suite 275 Sycamore IL 60178-3178 | |
| (815) 758-4189 | |
| (815) 758-4953 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 2540 Hauser-ross Drive, Sycamore, Illinois |
| Authorized Official Name and Position | Manav K Salwan (PHYSICIAN/PRESIDENT) |
| Authorized Official Contact | 8157584189 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2540 Hauser-ross Drive Suite 275 Sycamore IL 60178-3178 Ph: (815) 758-4189 | 2540 Hauser-ross Drive Suite 275 Sycamore IL 60178-3178 Ph: (815) 758-4189 |
| NPI Number | 1588832810 |
|---|---|
| Provider Enumeration Date | 02/20/2008 |
| Last Update Date | 04/30/2009 |
| Medicare PECOS PAC ID | 4183795545 |
|---|---|
| Medicare Enrollment ID | O20080612000746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588832810 | NPI | - | NPPES |
| 036116971 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036116971 (Illinois) | Secondary |
| 207R00000X | Internal Medicine | 036-116971 (Illinois) | Primary |
| Provider Name | Manav K Salwan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457424301 PECOS PAC ID: 6305846429 Enrollment ID: I20070112000417 |
| Provider Name | Ashima Salwan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871785923 PECOS PAC ID: 3577658582 Enrollment ID: I20071005000546 |
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