<unavail> in Bolingbrook, IL - Medicare Family Medicine

is a medicare enrolled primary clinic (Family Medicine) in Bolingbrook, Illinois. The current practice location for is 730 S Weber Rd, Unit G, Bolingbrook, Illinois. For appointments, you can reach them via phone at (630) 378-2000. The mailing address for is Po Box 215, Westmont, Illinois and phone number is () -.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1780606566. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (630) 378-2000.

Contact Information


	730 S Weber Rd Unit G Bolingbrook IL 60490-5472
	(630) 378-2000
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Family Medicine
Location	730 S Weber Rd, Bolingbrook, Illinois
Authorized Official Name and Position	Datta Sambare (PRESIDENT)
Authorized Official Contact	6303782000
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Po Box 215 Westmont IL 60559-0215 Ph: () -	730 S Weber Rd Unit G Bolingbrook IL 60490-5472 Ph: (630) 378-2000

NPI Details:

NPI Number	1780606566
Provider Enumeration Date	07/24/2006
Last Update Date	03/29/2016

Medicare PECOS Information:

Medicare PECOS PAC ID	9234199845
Medicare Enrollment ID	O20041018000376

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1780606566	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	(* (Not Available))	Primary
207R00000X	Internal Medicine	(* (Not Available))	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Dattatreya Sambare
Provider Type	Practitioner - Internal Medicine
Provider Identifiers	NPI Number: 1619911211 PECOS PAC ID: 6002876612 Enrollment ID: I20041019000080

Provider Name	Varsha Datta Sambare
Provider Type	Practitioner - Family Practice
Provider Identifiers	NPI Number: 1497775233 PECOS PAC ID: 6204877632 Enrollment ID: I20050517000120

Reviews and Comments

Family Medicine in Bolingbrook, IL

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- Medicare Primary Care in Bolingbrook, IL