Organization
CRIMSON ARK MEDICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JITENDRA KUMAR MOHINDRA (OWNER)
(630) 758-0630
Entity
Organization
Contact information
Practice address
516 S FAIRVIEW AVE, ELMHURST, IL 60126-3731
(630) 254-4337
Mailing address
386 N YORK RD, STE 100, ELMHURST, IL 60126-2363
(630) 758-0630
(630) 758-0632
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036089371
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001621386
BCBS
IL
05
—
036089371
—
IL
01
—
314990
MEDICARE FOR COOK COUNTY
IL
01
—
704890
MEDICARE DUPAGE COUNTY
IL
Enumeration date
06/03/2008
Last updated
06/03/2008
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