| Midwest Nephrology & Internal Medicine Associates, Corp. | |
|
1111 Superior St Suite 204 Melrose Park IL 60160-4156 | |
| (708) 689-8539 | |
| Not Available |
| Full Name | Midwest Nephrology & Internal Medicine Associates, Corp. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1111 Superior St, Melrose Park, Illinois |
| Authorized Official Name and Position | Rajani Kosuri (PRESIDENT) |
| Authorized Official Contact | 7086898539 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Nephrology & Internal Medicine Associates, Corp. Po Box 5391 Woodridge IL 60517-0391 Ph: (708) 689-8539 | Midwest Nephrology & Internal Medicine Associates, Corp. 1111 Superior St Suite 204 Melrose Park IL 60160-4156 Ph: (708) 689-8539 |
| NPI Number | 1700245982 |
|---|---|
| Provider Enumeration Date | 02/17/2016 |
| Last Update Date | 05/03/2019 |
| Medicare PECOS PAC ID | 4688973514 |
|---|---|
| Medicare Enrollment ID | O20160427002448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700245982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Rajani Kosuri |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1346455185 PECOS PAC ID: 1355418674 Enrollment ID: I20110603000492 |
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