| Internal Medicine Center | |
|
1909 Ogden Ave Downers Grove IL 60515-2602 | |
| (630) 241-1616 | |
| (630) 541-0066 |
| Full Name | Internal Medicine Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1909 Ogden Ave, Downers Grove, Illinois |
| Authorized Official Name and Position | Ravikiran N Tamragouri (PRESIDENT) |
| Authorized Official Contact | 6302411616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Center 1909 Ogden Ave Downers Grove IL 60515-2602 Ph: (630) 241-1616 | Internal Medicine Center 1909 Ogden Ave Downers Grove IL 60515-2602 Ph: (630) 241-1616 |
| NPI Number | 1588840607 |
|---|---|
| Provider Enumeration Date | 01/18/2008 |
| Last Update Date | 05/10/2010 |
| Medicare PECOS PAC ID | 2860523495 |
|---|---|
| Medicare Enrollment ID | O20100625000876 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588840607 | NPI | - | NPPES |
| 036073705 | Medicaid | IL | |
| 2215606 | Other | IL | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036073705 (Illinois) | Primary |
| Provider Name | Ravikiran N Tamragouri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831207430 PECOS PAC ID: 4688705213 Enrollment ID: I20100625000881 |
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