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Organization
SUBURBAN MEDICAL CLINIC LLC
Active
Organization
SUBURBAN MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANAND M THAKKAR MD (OWNER)
(630) 289-0440
Entity
Organization
Contact information
Practice address
1802 IRVING PARK RD, HANOVER PARK, IL 60133-3254
(630) 289-0440
(630) 289-0442
Mailing address
1802 IRVING PARK RD, HANOVER PARK, IL 60133-3254
(630) 289-0440
(630) 289-0442
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036112261
—
IL
Enumeration date
11/08/2010
Last updated
03/17/2018
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