| Veterans Administration | |
|
30 E 15th St Chicago Heights IL 60411-3459 | |
| (708) 756-5454 | |
| Not Available |
| Full Name | Veterans Administration |
|---|---|
| Speciality | Internal Medicine |
| Location | 30 E 15th St, Chicago Heights, Illinois |
| Authorized Official Name and Position | Sanjay Penmetcha (ATTENDING PHYSICIAN) |
| Authorized Official Contact | 7087565454 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Veterans Administration 7810 Circle Dr Burr Ridge IL 60527-8011 Ph: (630) 662-0393 | Veterans Administration 30 E 15th St Chicago Heights IL 60411-3459 Ph: (708) 756-5454 |
| NPI Number | 1518071877 |
|---|---|
| Provider Enumeration Date | 08/17/2006 |
| Last Update Date | 06/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518071877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036097423 (Illinois) | Primary |
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