Organization
MOHIN T SAMARAWEERA MD SC PLAINFIELD MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHIN TISSA SAMARAWEERA MD (DIRECTOR)
(815) 436-7303
Entity
Organization
Contact information
Practice address
24016 W MAIN ST, PLAINFIELD, IL 60544-2232
(815) 436-7303
(815) 609-7980
Mailing address
24016 W MAIN ST, PLAINFIELD, IL 60544-2232
(815) 436-7303
(815) 609-7980
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
36048836
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9900490
BC BS OF IL
IL
Enumeration date
03/16/2007
Last updated
09/12/2007
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