| Suburban Medical Clinic Llc | |
|
1802 Irving Park Rd Hanover Park IL 60133-3254 | |
| (630) 289-0440 | |
| (630) 289-0442 |
| Full Name | Suburban Medical Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1802 Irving Park Rd, Hanover Park, Illinois |
| Authorized Official Name and Position | Anand M Thakkar (OWNER) |
| Authorized Official Contact | 6302890440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suburban Medical Clinic Llc 1802 Irving Park Rd Hanover Park IL 60133-3254 Ph: (630) 289-0440 | Suburban Medical Clinic Llc 1802 Irving Park Rd Hanover Park IL 60133-3254 Ph: (630) 289-0440 |
| NPI Number | 1386945319 |
|---|---|
| Provider Enumeration Date | 11/08/2010 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 7618164005 |
|---|---|
| Medicare Enrollment ID | O20101210000772 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386945319 | NPI | - | NPPES |
| 036112261 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Illinois) | Primary |
| Provider Name | Anand Mahendrabhai Thakkar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336190040 PECOS PAC ID: 7113972019 Enrollment ID: I20050314000747 |
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