| Boling Medical Llc | |
|
899 S Weber Rd Suite G Bolingbrook IL 60490-5488 | |
| (630) 226-1800 | |
| (630) 226-4226 |
| Full Name | Boling Medical Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 899 S Weber Rd, Bolingbrook, Illinois |
| Authorized Official Name and Position | Suma Reddy Kaki (OPERATING MEMBER) |
| Authorized Official Contact | 6302261800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boling Medical Llc 899 S Weber Rd Suite G Bolingbrook IL 60490-5488 Ph: (630) 226-1800 | Boling Medical Llc 899 S Weber Rd Suite G Bolingbrook IL 60490-5488 Ph: (630) 226-1800 |
| NPI Number | 1003019894 |
|---|---|
| Provider Enumeration Date | 06/08/2007 |
| Last Update Date | 01/06/2015 |
| Medicare PECOS PAC ID | 1850473968 |
|---|---|
| Medicare Enrollment ID | O20080129000239 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003019894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Suma R Kaki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366451577 PECOS PAC ID: 0345345302 Enrollment ID: I20070419000346 |
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