| Soul Tab Llc | |
|
2300 Barrington Rd Ste 497 Hoffman Estates IL 60169-2082 | |
| (630) 936-9062 | |
| Not Available |
| Full Name | Soul Tab Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2300 Barrington Rd Ste 497, Hoffman Estates, Illinois |
| Authorized Official Name and Position | Baljit Singh (OWNER) |
| Authorized Official Contact | 6309369062 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Tab Llc 721 Blue Ridge Dr Streamwood IL 60107-4503 Ph: (630) 936-9062 | Soul Tab Llc 2300 Barrington Rd Ste 497 Hoffman Estates IL 60169-2082 Ph: (630) 936-9062 |
| NPI Number | 1295438471 |
|---|---|
| Provider Enumeration Date | 03/24/2023 |
| Last Update Date | 04/13/2023 |
| Medicare PECOS PAC ID | 2860857836 |
|---|---|
| Medicare Enrollment ID | O20230426000885 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295438471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mayank K Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962430272 PECOS PAC ID: 5597827444 Enrollment ID: I20081231000166 |
| Provider Name | Divya Babbar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245496835 PECOS PAC ID: 5395914311 Enrollment ID: I20110809000417 |
| Provider Name | Tiffany Kozlick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366075152 PECOS PAC ID: 0941659486 Enrollment ID: I20231211000059 |
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