Organization
SUBURBAN MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RITESH D PATEL M.D (PRESIDENT)
(847) 226-8900
Entity
Organization
Contact information
Practice address
1555 BARRINGTON RD BLDG 3, SUITE # 2500, HOFFMAN ESTATES, IL 60169-1019
(847) 226-8900
(224) 330-1665
Mailing address
PO BOX 967, TINLEY PARK, IL 60477-0967
(708) 532-6029
(708) 532-6095
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
036-115260
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001639510
BS PROVIDER #
IL
05
—
036115260
—
IL
01
—
216663
MEDICARE PTAN
IL
Enumeration date
05/20/2008
Last updated
09/18/2009
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