Chicagoland Healthcare Pc | |
1 S 376 Summit Ave Court C Unit 4-b Oakbrook Terrace IL 60181 | |
(847) 409-9345 | |
Not Available |
Full Name | Chicagoland Healthcare Pc |
---|---|
Speciality | Internal Medicine |
Location | 1 S 376 Summit Ave, Oakbrook Terrace, Illinois |
Authorized Official Name and Position | Krishdeep Khosla (OWNER) |
Authorized Official Contact | 8474099345 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Chicagoland Healthcare Pc 1 South 376 Summit Ave Court C Unit 4-b Oakbrook Terrace IL 60181-2226 Ph: (630) 953-9009 | Chicagoland Healthcare Pc 1 S 376 Summit Ave Court C Unit 4-b Oakbrook Terrace IL 60181 Ph: (847) 409-9345 |
NPI Number | 1316277999 |
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Provider Enumeration Date | 01/05/2010 |
Last Update Date | 06/03/2021 |
Medicare PECOS PAC ID | 4284522319 |
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Medicare Enrollment ID | O20040309001036 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316277999 | NPI | - | NPPES |
036099607 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036099607 (Illinois) | Primary |
Provider Name | Krishdeep Khosla |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1306899570 PECOS PAC ID: 7911895131 Enrollment ID: I20040309000918 |
Provider Name | Laura Cooper |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194336107 PECOS PAC ID: 7719391945 Enrollment ID: I20210131000012 |
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