| Srinivas C Kota Md Sc | |
|
1280 Windham Pkwy Romeoville IL 60446-1673 | |
| (630) 378-9785 | |
| (630) 378-9836 |
| Full Name | Srinivas C Kota Md Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1280 Windham Pkwy, Romeoville, Illinois |
| Authorized Official Name and Position | Srinivas C Kota (PRESIDENT) |
| Authorized Official Contact | 6303789785 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Srinivas C Kota Md Sc 1280 Windham Parkway Romeoville IL 60446-1673 Ph: (630) 378-9785 | Srinivas C Kota Md Sc 1280 Windham Pkwy Romeoville IL 60446-1673 Ph: (630) 378-9785 |
| NPI Number | 1689970360 |
|---|---|
| Provider Enumeration Date | 01/28/2011 |
| Last Update Date | 01/28/2011 |
| Medicare PECOS PAC ID | 5597936153 |
|---|---|
| Medicare Enrollment ID | O20110913000037 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689970360 | NPI | - | NPPES |
| 036095253 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036095253 (Illinois) | Primary |
| Provider Name | Srinivas C Kota |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659481562 PECOS PAC ID: 4385606144 Enrollment ID: I20041103000403 |
| Provider Name | Rachel J Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497763882 PECOS PAC ID: 4789782186 Enrollment ID: I20070608000247 |
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