| Premier Primary Care Physicians S.C. | |
|
371 S. Main Place Carol Stream IL 60188 | |
| (630) 260-2409 | |
| (630) 682-1960 |
| Full Name | Premier Primary Care Physicians S.C. |
|---|---|
| Speciality | Internal Medicine |
| Location | 371 S. Main Place, Carol Stream, Illinois |
| Authorized Official Name and Position | Nausheen Hasan (PRESIDENT) |
| Authorized Official Contact | 6302602409 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Primary Care Physicians S.C. 371 S. Main Place Carol Stream IL 60188 Ph: (630) 260-2409 | Premier Primary Care Physicians S.C. 371 S. Main Place Carol Stream IL 60188 Ph: (630) 260-2409 |
| NPI Number | 1427140557 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 07/30/2015 |
| Medicare PECOS PAC ID | 6305845363 |
|---|---|
| Medicare Enrollment ID | O20061220000465 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427140557 | NPI | - | NPPES |
| 0360963282 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036096328 (Illinois) | Primary |
| Provider Name | Nausheen Hasan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245321207 PECOS PAC ID: 8022017086 Enrollment ID: I20061220000489 |
| Provider Name | Kristin Otolski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689176703 PECOS PAC ID: 6305108705 Enrollment ID: I20180323000448 |
| Provider Name | Madeline M Mandoza |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497458251 PECOS PAC ID: 7113468208 Enrollment ID: I20240917000478 |
| Provider Name | Shreeyu Desai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235929654 PECOS PAC ID: 9931606738 Enrollment ID: I20251008001568 |
| Provider Name | Bijalben Arpitkumar Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477422566 PECOS PAC ID: 0042796294 Enrollment ID: I20260108000069 |
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