| Nani Internal Med LLC | |
|
6438 Joliet Rd Ste 203 Countryside IL 60525-4624 | |
| (708) 352-5222 | |
| Not Available |
| Full Name | Nani Internal Med LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 6438 Joliet Rd Ste 203, Countryside, Illinois |
| Authorized Official Name and Position | Manish Tanna (PRESIDENT) |
| Authorized Official Contact | 6305735000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nani Internal Med LLC 120 W 22nd St Oak Brook IL 60523-1557 Ph: (630) 974-5216 | Nani Internal Med LLC 6438 Joliet Rd Ste 203 Countryside IL 60525-4624 Ph: (708) 352-5222 |
| NPI Number | 1740765700 |
|---|---|
| Provider Enumeration Date | 09/26/2018 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/21/2024 |
| Medicare PECOS PAC ID | 6901141498 |
|---|---|
| Medicare Enrollment ID | O20190103001385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740765700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 207R00000X | Internal Medicine | () | Primary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | () | Secondary |
| Provider Name | Christopher P Brenner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629020102 PECOS PAC ID: 7810986874 Enrollment ID: I20040506001247 |
| Provider Name | Gerald Simon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861450330 PECOS PAC ID: 4688651334 Enrollment ID: I20050113000331 |
| Provider Name | Rudolph Albores |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285692889 PECOS PAC ID: 6406983402 Enrollment ID: I20100422001098 |
| Provider Name | David M Sachtleben |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861450447 PECOS PAC ID: 6204963200 Enrollment ID: I20100422001117 |
| Provider Name | Jacqueline J Celmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811245178 PECOS PAC ID: 8628214087 Enrollment ID: I20130410000156 |
Operator's Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6150 Joliet Rd, Countryside, IL 60525 Phone: 708-485-2273 Fax: 708-352-0845 |
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