SUBURBAN MEDICAL CLINIC LLC (NPI# 1386945319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386945319 |
| Entity Type | Organization |
| Organization Name | SUBURBAN MEDICAL CLINIC LLC |
| Practice Address |
1802 Irving Park Rd Hanover Park IL 60133-3254 |
| Practice Telephone | 6302890440 |
| Practice Fax Number | 6302890442 |
| Mailing Telephone | 6302890440 |
| Mailing Fax Number | 6302890442 |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | ANAND M THAKKAR (OWNER) |
| Authorized Official Telephone | 6302890440 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036112261 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1601 Tanglewood Ave, Suite 105, Hanover Park, IL 601333381 | 6302890440 | 6302890442 |
| Street Address |
1802 IRVING PARK RD |
| City | HANOVER PARK |
| State | IL |
| Zip Code | 60133-3254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467478552 | Bradley Hiroshi Hayashi | Chiropractor | 1802 Irving Park Rd, Hanover Park, IL 60133 | 2006-07-14 |
| 1508315268 | Hanover Pharmacy, LLC. | Pharmacy | 1802 Irving Park Rd, Suite 201, Hanover Park, IL 60133-3254 | 2016-09-22 |
| 1356393813 | Bruce M. Klein | Chiropractor | 1802 Irving Park Rd, Hanover Park, IL 60133-3254 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215302922 | Mangal Dhami | Pharmacist | 1877 Grosse Pointe Circle, Hanove Park, IL 60133 | 2015-12-07 |
| 1649588260 | Church Street Station Skilled Nursing and Living Center, LLC | Skilled Nursing Facility | 2000 W. Lake St., Hanover Park, IL 60133 | 2010-09-16 |
| 1578603395 | Shyam V N Rao | Dentist | 1601 Tanglewood Avenue, Hanover Park, IL 60133 | 2007-02-08 |
| 1851458939 | Robert Jan Bazan | Dentist | 2260 W Irving Pk Rd, Hanover Pk, IL 60133 | 2007-01-02 |
| 1215018635 | Alexian Brothers Corporate Health Services | Clinic/Center | 1515 W Lake Street, Ste 100, Hanover Park, IL 60133 | 2006-10-19 |
| 1225120462 | Hanover Park Physical Medicine & Rehabilitation Ltd | Chiropractor | 1802 Irving Park Road, Hanover Park, IL 60133 | 2006-09-28 |
| 1447350830 | Ismail E Atcha | Internal Medicine | 5420 Cloverdale Road, Hanover Park, ILLINOIS 60133 | 2006-09-25 |
| 1013013374 | Antonio B Cruz | General Practice | 1601 Tanglewood, Suite 106, Hanover Park, IL 60133 | 2006-09-15 |
| 1326143223 | Matthew J Faith | Dentist | 1645 Irving Park Road, Hanover Park, IL 60133 | 2006-09-14 |
| 1992818827 | Ketan Narandas Jobanputra | Obstetrics & Gynecology | 1515 West Lake Street, #208, Alexian Brothers' Hospital Pavilion, Hanover Park, IL 60133 | 2006-08-16 |
| Find all providers in zip 60133 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447350830 | Ismail E Atcha | Internal Medicine | 5420 Cloverdale Road, Hanover Park, ILLINOIS 60133 | 2006-09-25 |
| 1336190040 | Anand M Thakkar | Internal Medicine | 1601 Tanglewood Ave, Suite 105, Hanover Park, IL 60133-3381 | 2006-05-15 |
| 1447562905 | Priya Dileep | Internal Medicine | 1515 E Lake St, Hanover Park, IL 60133-4869 | 2010-07-12 |
| 1033361647 | Ls Medical Group,l.l.c. | Internal Medicine | 1515 E Lake St, Suite 208, Hanover Park, IL 60133-4896 | 2008-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002832 | Coleman Clinic, Inc. | Internal Medicine | 1893 Daimler Rd Ste A, Rockford, IL 61112-1081 | 2020-10-29 |
| 1922606193 | Thatiana Carolina Schulze Goni | Internal Medicine | 5924 N Lincoln Ave Apt 205, Chicago, IL 60659-3736 | 2020-10-11 |
| 1447866579 | Jashan Gill | Internal Medicine | 3707 Doty Rd Ste Eandf, Woodstock, IL 60098-7530 | 2020-09-23 |
| 1649884636 | Maria Detolve Donoghue | Internal Medicine | 905 Eldorado St, Winnetka, IL 60093-1951 | 2020-09-07 |
| 1750995742 | Eva Bartaula | Internal Medicine | 1500 S Fairfield Ave # 3, Chicago, IL 60608-1782 | 2020-09-07 |
| 1750994513 | Ranjit Babu Jasaraj | Internal Medicine | 1500 S Fairfield Ave # F-914, Chicago, IL 60608-1782 | 2020-08-30 |
| 1871106005 | Vijay Ketan Reddy | Internal Medicine | 1500 S Fairfield Ave Dept Roomf914, Chicago, IL 60608-1782 | 2020-08-27 |
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1417566084 | Avani Sushilkumar Mohta | Internal Medicine | Carle Foundation Hospital, 611 W. Park Street, Urbana, IL 61801 | 2020-07-29 |
| 1659989937 | Consultant Physicians | Internal Medicine | 580 Bankview Dr, Frankfort, IL 60423-1382 | 2020-07-22 |
| Find all providers with the same taxonomy | ||||
| City | HANOVER PARK |
| Zip Code | 60133 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.