Dr Banu Prasad Myneni, DO | |
7734 W North Ave, Elmwood Park, IL 60707-4124 | |
(708) 660-3900 | |
Not Available |
Full Name | Dr Banu Prasad Myneni |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 9 Years |
Location | 7734 W North Ave, Elmwood Park, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780082693 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 036-144866 (Illinois) | Secondary |
207Q00000X | Family Medicine | 0102206019 (Virginia) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Bon Secours Maryview Medical Center | Portsmouth, VA | Hospital |
Sentara Obici Hospital | Suffolk, VA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Legacy Healthcare Services Inc | 2163339722 | 2654 |
Privia Medical Group Llc | 4385682061 | 1176 |
Entity Name | Privia Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013042480 PECOS PAC ID: 4385682061 Enrollment ID: O20140603000011 |
Mailing Address | Practice Location Address |
---|---|
Dr Banu Prasad Myneni, DO 3235 Academy Ave, Portsmouth, VA 23703-3200 Ph: (757) 484-7386 | Dr Banu Prasad Myneni, DO 7734 W North Ave, Elmwood Park, IL 60707-4124 Ph: (708) 660-3900 |
Richard A Kasufkin, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 7230 W North Ave Ste 106b, Resurrection Immediate Care Center, Elmwood Park, IL 60707 Phone: 708-453-3000 Fax: 708-453-4660 | |
Dr. Susan Marie Locke, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 7255 W Grand Ave, Elmwood Park, IL 60707 Phone: 708-327-1650 | |
Kathryn J Mencel, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7740 W North Ave, Elmwood Park, IL 60707 Phone: 708-456-3200 Fax: 708-456-3427 | |
Frederick Allan Barber, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 7632 W North Ave, West Suburban Family Practice Assoc Ltd, Elmwood Park, IL 60707 Phone: 708-451-4420 Fax: 708-456-9817 | |
Alicja B Poleszak, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7740 W North Ave, Elmwood Park, IL 60707 Phone: 708-456-3200 Fax: 708-456-3427 | |
John J Walsh, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7632 W North Ave, Elmwood Park, IL 60707 Phone: 708-456-4420 Fax: 708-456-9817 |