| West Northwest Suburban Community Health Center | |
|
1252 Ogden Ave Downers Grove IL 60515-2740 | |
| (630) 963-6912 | |
| (630) 963-1499 |
| Full Name | West Northwest Suburban Community Health Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 1252 Ogden Ave, Downers Grove, Illinois |
| Authorized Official Name and Position | Mohammad Vaseemuddin (PRESIDENT) |
| Authorized Official Contact | 6309636912 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Northwest Suburban Community Health Center 1252 Ogden Ave Downers Grove IL 60515-2740 Ph: (630) 963-6912 | West Northwest Suburban Community Health Center 1252 Ogden Ave Downers Grove IL 60515-2740 Ph: (630) 963-6912 |
| NPI Number | 1326785338 |
|---|---|
| Provider Enumeration Date | 05/19/2022 |
| Last Update Date | 09/24/2023 |
| Medicare PECOS PAC ID | 7012393879 |
|---|---|
| Medicare Enrollment ID | O20220930001948 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326785338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Mohammad Vaseemuddin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952453995 PECOS PAC ID: 4789625542 Enrollment ID: I20050523000107 |
| Provider Name | Shah Aziz Alam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164450672 PECOS PAC ID: 3173542305 Enrollment ID: I20051117000186 |
| Provider Name | Michael G Close |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992893184 PECOS PAC ID: 5698786663 Enrollment ID: I20060505000663 |
| Provider Name | Nancy Qusba |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1235269788 PECOS PAC ID: 8628106937 Enrollment ID: I20100506000919 |
| Provider Name | Ambar Josefina Cantu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144829714 PECOS PAC ID: 7517370166 Enrollment ID: I20201229000807 |
| Provider Name | Nina R Defrias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851961916 PECOS PAC ID: 2769870039 Enrollment ID: I20211020000139 |
| Provider Name | Monique L Szczepanik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558088427 PECOS PAC ID: 2567823933 Enrollment ID: I20230801003283 |
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