Organization
SC MOHAN MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANGARAPILLAI MOHAN MD (CHIEF OPERATING OFFICER)
(773) 989-9868
Entity
Organization
Contact information
Practice address
4755 N KENMORE AVE, CHICAGO, IL 60640-5015
(773) 989-9868
(773) 751-2250
Mailing address
103 SAINT FRANCIS CIR, OAK BROOK, IL 60523-2559
(773) 989-9868
(773) 751-2250
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036057255
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057255
—
IL
Enumeration date
04/18/2008
Last updated
10/29/2008
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