| V Susarla Mdsc | |
|
860 Summit St Suite 123 Elgin IL 60120-5145 | |
| (847) 741-0026 | |
| Not Available |
| Full Name | V Susarla Mdsc |
|---|---|
| Speciality | Internal Medicine |
| Location | 860 Summit St, Elgin, Illinois |
| Authorized Official Name and Position | Viswanatham Susarla (PHYSICIAN) |
| Authorized Official Contact | 8477410026 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| V Susarla Mdsc 860 Summit St Suite 123 Elgin IL 60120-5145 Ph: (847) 741-0026 | V Susarla Mdsc 860 Summit St Suite 123 Elgin IL 60120-5145 Ph: (847) 741-0026 |
| NPI Number | 1952583783 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 12/21/2007 |
| Medicare PECOS PAC ID | 2860400348 |
|---|---|
| Medicare Enrollment ID | O20060324000185 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952583783 | NPI | - | NPPES |
| DE4313 | Other | IL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Viswanatham Susarla |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1922014315 PECOS PAC ID: 8123036605 Enrollment ID: I20060327000096 |
| Provider Name | Savitha Susarla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518976323 PECOS PAC ID: 1254349715 Enrollment ID: I20060327000108 |
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