| Dr Sujal V Panchal, MD | |
|
100 Batson Ct, Suite 106, New Lenox, IL 60451-1564 | |
| (815) 463-9747 | |
| (815) 463-9749 |
| Full Name | Dr Sujal V Panchal |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 100 Batson Ct, New Lenox, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629174024 | NPI | - | NPPES |
| 036119020 | Medicaid | IL | |
| HSP40248F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 036119020 (Illinois) | Secondary |
| 208000000X | Pediatrics | A82152 (California) | Secondary |
| 208000000X | Pediatrics | 4301106399 (Michigan) | Primary |
| Entity Name | Henry Ford Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134144801 PECOS PAC ID: 0547178311 Enrollment ID: O20031105000139 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Sujal V Panchal, MD 100 Batson Ct, Suite 106, New Lenox, IL 60451-1564 Ph: (815) 463-9747 | Dr Sujal V Panchal, MD 100 Batson Ct, Suite 106, New Lenox, IL 60451-1564 Ph: (815) 463-9747 |
Jonette P Belicena, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1870 Silver Cross Blvd Ste 240, New Lenox, IL 60451 Phone: 815-514-2600 Fax: 815-463-0964 | |
Paul Tortoriello, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1870 Silver Cross Blvd Ste 240, New Lenox, IL 60451 Phone: 815-514-2600 Fax: 815-463-0964 | |
Dr. Mourice S Nemri, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 100 Batson Ct, Suite 106, New Lenox, IL 60451 Phone: 815-463-9747 Fax: 815-463-9749 | |
Dr. Akilah L Cook, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1005 W Laraway Rd Ste 230, New Lenox, IL 60451 Phone: 815-934-8444 Fax: 815-717-7229 |