| St Mary Internal Medicine Associates S C | |
|
2320 S Route 59 Plainfield IL 60586-7756 | |
| (815) 609-9480 | |
| (815) 609-9482 |
| Full Name | St Mary Internal Medicine Associates S C |
|---|---|
| Speciality | Clinic/Center |
| Location | 2320 S Route 59, Plainfield, Illinois |
| Authorized Official Name and Position | Ashraf Assaad Iskander (PRESIDENT) |
| Authorized Official Contact | 8156099480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Mary Internal Medicine Associates S C 2320 S Route 59 Plainfield IL 60586-7756 Ph: (815) 609-9480 | St Mary Internal Medicine Associates S C 2320 S Route 59 Plainfield IL 60586-7756 Ph: (815) 609-9480 |
| NPI Number | 1710009204 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 11/30/2010 |
| Medicare PECOS PAC ID | 9931395084 |
|---|---|
| Medicare Enrollment ID | O20101201000379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710009204 | NPI | - | NPPES |
| 036094077 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036094077 (Illinois) | Primary |
| Provider Name | Ashraf A Iskander |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437167541 PECOS PAC ID: 0840486999 Enrollment ID: I20101201000446 |
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