| Gastroenterologists Ltd | |
|
1105 W Park Ave Ste 1 Libertyville IL 60048-2567 | |
| (847) 680-5880 | |
| (847) 680-5881 |
| Full Name | Gastroenterologists Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 1105 W Park Ave Ste 1, Libertyville, Illinois |
| Authorized Official Name and Position | Rashida R (MANAGER) |
| Authorized Official Contact | 8476805880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterologists Ltd 1105 W Park Ave Ste 1 Libertyville IL 60048-2567 Ph: (847) 680-5880 | Gastroenterologists Ltd 1105 W Park Ave Ste 1 Libertyville IL 60048-2567 Ph: (847) 680-5880 |
| NPI Number | 1891993606 |
|---|---|
| Provider Enumeration Date | 07/03/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3274422886 |
|---|---|
| Medicare Enrollment ID | O20040312000067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891993606 | NPI | - | NPPES |
| 4901136 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (Illinois) | Primary |
| Provider Name | Michael P Viglione |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073581146 PECOS PAC ID: 7113823972 Enrollment ID: I20031211000374 |
| Provider Name | Mohammad H Bawani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407858152 PECOS PAC ID: 6608765243 Enrollment ID: I20040312000233 |
| Provider Name | Wenhua Liu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1366591729 PECOS PAC ID: 1153422639 Enrollment ID: I20070727000528 |
| Provider Name | Kimko Suzue |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1629233408 PECOS PAC ID: 3870661762 Enrollment ID: I20081006000144 |
| Provider Name | David D Wang |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1548238611 PECOS PAC ID: 6800792029 Enrollment ID: I20100722000421 |
| Provider Name | Shreenath Bishu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1477703189 PECOS PAC ID: 9234308396 Enrollment ID: I20110805000148 |
| Provider Name | Shiwen Song |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1538396726 PECOS PAC ID: 2466646278 Enrollment ID: I20140603002445 |
| Provider Name | David Arps |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1770804312 PECOS PAC ID: 6901118488 Enrollment ID: I20160523001961 |
| Provider Name | Kristen M Paral |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1508177668 PECOS PAC ID: 9830479641 Enrollment ID: I20180328000442 |
| Provider Name | Timothy Tan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205272507 PECOS PAC ID: 7719223999 Enrollment ID: I20200616002534 |
| Provider Name | Rosalind Sharain |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1306270152 PECOS PAC ID: 0345474953 Enrollment ID: I20210406000024 |
| Provider Name | Jie Song |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1114223351 PECOS PAC ID: 7416135942 Enrollment ID: I20230421000922 |
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