| Healthstop Sc | |
|
3635 S Harlem Ave Berwyn IL 60402-3212 | |
| (708) 447-9402 | |
| (708) 447-3246 |
| Full Name | Healthstop Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 3635 S Harlem Ave, Berwyn, Illinois |
| Authorized Official Name and Position | Manohar Jethani (PRESIDENT) |
| Authorized Official Contact | 7084479402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthstop Sc 3635 S Harlem Ave Berwyn IL 60402-3212 Ph: (708) 447-9402 | Healthstop Sc 3635 S Harlem Ave Berwyn IL 60402-3212 Ph: (708) 447-9402 |
| NPI Number | 1225684640 |
|---|---|
| Provider Enumeration Date | 08/12/2019 |
| Last Update Date | 08/12/2019 |
| Medicare PECOS PAC ID | 6305176884 |
|---|---|
| Medicare Enrollment ID | O20190926000147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225684640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Manohar L Jethani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366529505 PECOS PAC ID: 6406923648 Enrollment ID: I20080930000317 |
| Provider Name | Melissa N Toulios |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912207036 PECOS PAC ID: 4880877018 Enrollment ID: I20110325000575 |
| Provider Name | Jennifer L Dunlop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912352089 PECOS PAC ID: 3274829791 Enrollment ID: I20160909001587 |
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