Swan Primary Care Pllc | |
303 E Army Trail Rd Ste 111 Bloomingdale IL 60108-2140 | |
(630) 931-2929 | |
(833) 731-0578 |
Full Name | Swan Primary Care Pllc |
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Speciality | Internal Medicine |
Location | 303 E Army Trail Rd Ste 111, Bloomingdale, Illinois |
Authorized Official Name and Position | Sunnan Moinuddin (OWNER) |
Authorized Official Contact | 6304560307 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Swan Primary Care Pllc 303 E Army Trail Rd Ste 111 Bloomingdale IL 60108-2140 Ph: (630) 931-2929 | Swan Primary Care Pllc 303 E Army Trail Rd Ste 111 Bloomingdale IL 60108-2140 Ph: (630) 931-2929 |
NPI Number | 1376137083 |
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Provider Enumeration Date | 02/23/2021 |
Last Update Date | 01/23/2024 |
Medicare PECOS PAC ID | 1951717016 |
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Medicare Enrollment ID | O20210316000294 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376137083 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Rohini Attavane |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447771860 PECOS PAC ID: 4688932346 Enrollment ID: I20171229001993 |
Provider Name | Sunnan Moinuddin |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1497140727 PECOS PAC ID: 0143524199 Enrollment ID: I20180828003683 |
Provider Name | Wahaj Ahmed |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1750834628 PECOS PAC ID: 7517211048 Enrollment ID: I20190404000324 |
Provider Name | Lisa Vasquez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336793298 PECOS PAC ID: 7719311620 Enrollment ID: I20200102000139 |
Provider Name | Rose M Hernandez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699337329 PECOS PAC ID: 1951738475 Enrollment ID: I20200224000425 |
Provider Name | Margeret Kiggundu |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1265042402 PECOS PAC ID: 0345656203 Enrollment ID: I20210302000420 |
Provider Name | Moiz Suhail |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1255825543 PECOS PAC ID: 9436493541 Enrollment ID: I20211026000076 |
Provider Name | Rashidah Sembatya |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376297093 PECOS PAC ID: 1759777964 Enrollment ID: I20220414001825 |
Provider Name | Annmary Kachappilly |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477294809 PECOS PAC ID: 7618354804 Enrollment ID: I20220509001315 |
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