| Lifespan Medical Associates Llc | |
|
724 E Kensington Rd Arlington Heights IL 60004-6201 | |
| (847) 222-9595 | |
| (847) 222-9565 |
| Full Name | Lifespan Medical Associates Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 724 E Kensington Rd, Arlington Heights, Illinois |
| Authorized Official Name and Position | Bino Oommen (OWNER OF ENTITY) |
| Authorized Official Contact | 7733013921 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifespan Medical Associates Llc 724 E Kensington Rd Arlington Heights IL 60004-6201 Ph: (847) 222-9595 | Lifespan Medical Associates Llc 724 E Kensington Rd Arlington Heights IL 60004-6201 Ph: (847) 222-9595 |
| NPI Number | 1356518559 |
|---|---|
| Provider Enumeration Date | 05/15/2008 |
| Last Update Date | 09/14/2021 |
| Medicare PECOS PAC ID | 0042386922 |
|---|---|
| Medicare Enrollment ID | O20080828000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356518559 | NPI | - | NPPES |
| 036119123 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Bino Varghese Oommen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235315995 PECOS PAC ID: 4688740566 Enrollment ID: I20080828000333 |
| Provider Name | Bindu Titus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033653340 PECOS PAC ID: 8022394204 Enrollment ID: I20171025003429 |
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