| Tt Medical Group Llc | |
|
741 S Mchenry Ave Ste C&d Crystal Lake IL 60014-7445 | |
| (815) 770-2780 | |
| (815) 770-2780 |
| Full Name | Tt Medical Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 741 S Mchenry Ave Ste C&d, Crystal Lake, Illinois |
| Authorized Official Name and Position | Ruchir Thakkar (PARTNER) |
| Authorized Official Contact | 8473227149 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tt Medical Group Llc 741 S Mchenry Ave Ste C&d Crystal Lake IL 60014-7445 Ph: (815) 770-2780 | Tt Medical Group Llc 741 S Mchenry Ave Ste C&d Crystal Lake IL 60014-7445 Ph: (815) 770-2780 |
| NPI Number | 1215528922 |
|---|---|
| Provider Enumeration Date | 01/27/2021 |
| Last Update Date | 08/04/2021 |
| Medicare PECOS PAC ID | 1052727682 |
|---|---|
| Medicare Enrollment ID | O20210305002083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215528922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Reji Ninan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144486721 PECOS PAC ID: 0042481699 Enrollment ID: I20110912000687 |
| Provider Name | Ruchir L Thakkar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174812853 PECOS PAC ID: 2264654888 Enrollment ID: I20141117000023 |
| Provider Name | Wyvon L Blackwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821398397 PECOS PAC ID: 8123340403 Enrollment ID: I20141124001757 |
| Provider Name | Mohanjit K Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619371267 PECOS PAC ID: 7719209774 Enrollment ID: I20141201002123 |
| Provider Name | Amy Ruth Sheffield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598156705 PECOS PAC ID: 2668522517 Enrollment ID: I20150602001538 |
| Provider Name | Rinku H Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528325321 PECOS PAC ID: 0345550984 Enrollment ID: I20151110002161 |
| Provider Name | Deepa Vallikat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407241425 PECOS PAC ID: 2365730876 Enrollment ID: I20161017002417 |
| Provider Name | Lyndsey Perreault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922547843 PECOS PAC ID: 9638455389 Enrollment ID: I20170411002051 |
| Provider Name | Sonja Enge-gilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659823458 PECOS PAC ID: 3375818065 Enrollment ID: I20171005001800 |
| Provider Name | Megan M Kotlarz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750757845 PECOS PAC ID: 9436451796 Enrollment ID: I20171025000118 |
| Provider Name | Manan Trivedi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194067298 PECOS PAC ID: 5294045621 Enrollment ID: I20180731000532 |
| Provider Name | Jessica L Frith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073003463 PECOS PAC ID: 4880947902 Enrollment ID: I20181018003082 |
| Provider Name | Nancy Quezada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649752023 PECOS PAC ID: 3779822242 Enrollment ID: I20190227001673 |
| Provider Name | Tia J Hanke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568014843 PECOS PAC ID: 6709117740 Enrollment ID: I20191007000836 |
| Provider Name | Sisenia Cortes Salinas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548819808 PECOS PAC ID: 2567793870 Enrollment ID: I20191016003506 |
| Provider Name | Shaikh Nadeem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114695178 PECOS PAC ID: 8022416510 Enrollment ID: I20211014000288 |
| Provider Name | Saarim Mohammad Ansari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831687565 PECOS PAC ID: 9335533603 Enrollment ID: I20220302001896 |
| Provider Name | Krishna Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588231120 PECOS PAC ID: 6406240415 Enrollment ID: I20220308000512 |
| Provider Name | Yekaterina S Noble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891404521 PECOS PAC ID: 3173993581 Enrollment ID: I20221229001770 |
| Provider Name | Crystal Elena Estrada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720782154 PECOS PAC ID: 5698137818 Enrollment ID: I20230818002168 |
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