Organization
COVENANT PHYSIATRY,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDHYA R MEESALA MD (PHYSICIAN/OWNER)
(847) 852-6478
Entity
Organization
Contact information
Practice address
1590 W ALGONQUIN RD, SUITE 167, HOFFMAN ESTATES, IL 60192-1575
(847) 852-6478
(847) 382-1646
Mailing address
PO BOX 967, TINLEY PARK, IL 60477-0967
(708) 532-6029
(708) 532-6095
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036110423
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001638924
BS#
IL
05
—
036110423
—
IL
Enumeration date
04/02/2008
Last updated
06/29/2015
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