| Thakkar S.c. | |
|
2015 Dean St #2 St Charles IL 60174-1577 | |
| (630) 584-2400 | |
| (630) 584-2404 |
| Full Name | Thakkar S.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 2015 Dean St, St Charles, Illinois |
| Authorized Official Name and Position | Jay Thakkar (PRESIDENT) |
| Authorized Official Contact | 6305842400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thakkar S.c. 2015 Dean St #2 St Charles IL 60174-1577 Ph: (630) 584-2400 | Thakkar S.c. 2015 Dean St #2 St Charles IL 60174-1577 Ph: (630) 584-2400 |
| NPI Number | 1801915616 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 03/05/2014 |
| Medicare PECOS PAC ID | 0345395828 |
|---|---|
| Medicare Enrollment ID | O20090904000438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801915616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036100883 (Illinois) | Primary |
| Provider Name | Hemalini J Thakkar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407940513 PECOS PAC ID: 0143375626 Enrollment ID: I20091104000256 |
| Provider Name | Jay Thakkar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780778977 PECOS PAC ID: 6507911088 Enrollment ID: I20100827000151 |
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