| Suriya Sastri, Mdpc | |
|
6900 S Madison St Suite 102 Willowbrook IL 60527-5510 | |
| (630) 325-8684 | |
| (630) 325-2490 |
| Full Name | Suriya Sastri, Mdpc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6900 S Madison St, Willowbrook, Illinois |
| Authorized Official Name and Position | Suriya V Sastri (PRESIDENT) |
| Authorized Official Contact | 6303258684 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Suriya Sastri, Mdpc 6900 Madison Street Suite - 102 Willowbrook IL 60527 Ph: (630) 325-8684 | Suriya Sastri, Mdpc 6900 S Madison St Suite 102 Willowbrook IL 60527-5510 Ph: (630) 325-8684 |
| NPI Number | 1023387040 |
|---|---|
| Provider Enumeration Date | 12/20/2011 |
| Last Update Date | 06/16/2018 |
| Medicare PECOS PAC ID | 3173787157 |
|---|---|
| Medicare Enrollment ID | O20120605000193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023387040 | NPI | - | NPPES |
| 036068118 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 036068118 (Illinois) | Primary |
| Provider Name | Suriya V Sastri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316904816 PECOS PAC ID: 4880725688 Enrollment ID: I20100623000023 |
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