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Organization
VETERANS ADMINISTRATION
Active
Organization
VETERANS ADMINISTRATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANJAY PENMETCHA MD (ATTENDING PHYSICIAN)
(708) 756-5454
Entity
Organization
Contact information
Practice address
30 E 15TH ST, CHICAGO HEIGHTS, IL 60411-3459
(708) 756-5454
Mailing address
7810 CIRCLE DR, BURR RIDGE, IL 60527-8011
(630) 662-0393
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036097423
IL
Other
Enumeration date
08/17/2006
Last updated
06/18/2008
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