INTERNAL MEDICINE CENTER NPI 1588840607

NPI Information

NPI: 1588840607
Provider Name: INTERNAL MEDICINE CENTER
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 14D0720399

Address:
1909 OGDEN AVE
DOWNERS GROVE, IL
ZIP 60515
Phone: (630) 241-1616
Get Directions

INTERNAL MEDICINE CENTER is a primary care clinic center in Downers Grove, IL. INTERNAL MEDICINE CENTER NPI is 1588840607. The provider is registered as an organization entity type.

The provider's business location address is:

1909 OGDEN AVE
DOWNERS GROVE, IL
ZIP 60515-602
Phone: (630) 241-1616
Fax: (630) 541-0066

The provider's authorized official is Ravikiran N Tamragouri .
The authorized official title is President and has the following contact phone number (630) 241-1616.

The CLIA number assigned to this NPI record is 14D0720399 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/18/2008 and was last updated on 5/10/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	036073705	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	ILLINOIS	HUMANA
2	E49140	MEDICARE UPIN	ILLINOIS
3	0=========	MEDICAID	ILLINOIS
4	036073705	MEDICAID	ILLINOIS
5	=========	OTHER	ILLINOIS	UNITED HEALTH CARE
6	=========	OTHER	ILLINOIS	AETNA
7	=========	OTHER	ILLINOIS	CIGNA
8	925290	MEDICARE PIN	ILLINOIS
9	2215606	OTHER	ILLINOIS	BLUE CROSS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »