Summit Healthcare Services Llc | |
4350 7th St Moline IL 61265-6870 | |
(309) 764-5040 | |
Not Available |
Full Name | Summit Healthcare Services Llc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 4350 7th St, Moline, Illinois |
Authorized Official Name and Position | Jamsheed H Khan (PRESIDENT) |
Authorized Official Contact | 8477495728 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Summit Healthcare Services Llc 1s376 Summit Ave Unit 6 D Court E Oakbrook Terrace IL 60181 Ph: (309) 764-5040 | Summit Healthcare Services Llc 4350 7th St Moline IL 61265-6870 Ph: (309) 764-5040 |
NPI Number | 1568273217 |
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Provider Enumeration Date | 01/14/2025 |
Last Update Date | 01/14/2025 |
Certification Date | 01/14/2025 |
Medicare PECOS PAC ID | 7719416254 |
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Medicare Enrollment ID | O20250128003573 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568273217 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
Provider Name | Jamsheed H Khan |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1578850277 PECOS PAC ID: 6002133261 Enrollment ID: I20220614001555 |
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