| Key Internal Medicine, S.c. | |
|
100 Provena Way Ste D Bourbonnais IL 60914 | |
| (815) 932-9210 | |
| (815) 932-9220 |
| Full Name | Key Internal Medicine, S.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 Provena Way Ste D, Bourbonnais, Illinois |
| Authorized Official Name and Position | Dharam R Anand (OWNER) |
| Authorized Official Contact | 8159329210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Key Internal Medicine, S.c. Po Box 715 Bourbonnais IL 60914-0715 Ph: (815) 932-9210 | Key Internal Medicine, S.c. 100 Provena Way Ste D Bourbonnais IL 60914 Ph: (815) 932-9210 |
| NPI Number | 1447308176 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 06/22/2023 |
| Medicare PECOS PAC ID | 7315849353 |
|---|---|
| Medicare Enrollment ID | O20040121000950 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447308176 | NPI | - | NPPES |
| 4632036 | Other | IL | BCBS PROVIDER NUMBER |
| 036076865 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036-076865 (Illinois) | Primary |
| Provider Name | Dharam R Anand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134107170 PECOS PAC ID: 0143122028 Enrollment ID: I20040128000024 |
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