| Ahuja Bariatric & Beyond | |
|
4230 Lincolnshire Dr Ste A Mount Vernon IL 62864-2189 | |
| (618) 315-6466 | |
| (618) 315-6469 |
| Full Name | Ahuja Bariatric & Beyond |
|---|---|
| Speciality | Surgery |
| Location | 4230 Lincolnshire Dr Ste A, Mount Vernon, Illinois |
| Authorized Official Name and Position | Naresh Ahuja (MEMBER) |
| Authorized Official Contact | 6182422317 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ahuja Bariatric & Beyond Po Box 675 Mount Vernon IL 62864-0014 Ph: (618) 242-2317 | Ahuja Bariatric & Beyond 4230 Lincolnshire Dr Ste A Mount Vernon IL 62864-2189 Ph: (618) 315-6466 |
| NPI Number | 1053043885 |
|---|---|
| Provider Enumeration Date | 06/29/2022 |
| Last Update Date | 09/23/2026 |
| Certification Date | 09/23/2026 |
| Medicare PECOS PAC ID | 6901289347 |
|---|---|
| Medicare Enrollment ID | O20220817001520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053043885 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | () | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | () | Secondary |
| 208600000X | Surgery | () | Primary |
| Provider Name | Issa Abedmahmoud |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1528042975 PECOS PAC ID: 1153425061 Enrollment ID: I20070403000227 |
| Provider Name | Autumn Wills |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437286671 PECOS PAC ID: 8123100898 Enrollment ID: I20080204000136 |
| Provider Name | Naresh K Ahuja |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013174598 PECOS PAC ID: 9830263870 Enrollment ID: I20100720000005 |
| Provider Name | Reno K Ahuja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619107968 PECOS PAC ID: 4587822408 Enrollment ID: I20120223000712 |
| Provider Name | Kerry Lynn Pitchford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205455763 PECOS PAC ID: 0143641126 Enrollment ID: I20200529000309 |
| Provider Name | Poorva Talapatra |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013210194 PECOS PAC ID: 1355784794 Enrollment ID: I20240213001574 |
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