| Suburban Healthcare Associates | |
|
13415 S Route 59 Plainfield IL 60585-5676 | |
| (815) 609-3627 | |
| (815) 609-1328 |
| Full Name | Suburban Healthcare Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 13415 S Route 59, Plainfield, Illinois |
| Authorized Official Name and Position | Sanjay Pethkar (PRESIDENT) |
| Authorized Official Contact | 8156093627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suburban Healthcare Associates Po Box 9200 Naperville IL 60567-0200 Ph: (815) 609-3627 | Suburban Healthcare Associates 13415 S Route 59 Plainfield IL 60585-5676 Ph: (815) 609-3627 |
| NPI Number | 1588873293 |
|---|---|
| Provider Enumeration Date | 05/21/2007 |
| Last Update Date | 10/31/2007 |
| Medicare PECOS PAC ID | 9830282565 |
|---|---|
| Medicare Enrollment ID | O20070911000423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588873293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036091255 (Illinois) | Primary |
| Provider Name | Sanjay Pethkar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134181829 PECOS PAC ID: 8123111853 Enrollment ID: I20070911000401 |
| Provider Name | Gabriel Lemus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285821868 PECOS PAC ID: 2567539620 Enrollment ID: I20080916000376 |
| Provider Name | Maureen Ochoa Dela Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467767566 PECOS PAC ID: 3577689421 Enrollment ID: I20121217000037 |
| Provider Name | Sushma Nagabhairava |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710265822 PECOS PAC ID: 1456591908 Enrollment ID: I20150724012340 |
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