Organization
SURESH H. WADHWANI, MD, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURESH H WADHWANI M.D. (PRESIDENT)
(815) 936-3250
Entity
Organization
Contact information
Practice address
455 W COURT ST, SUITE 302, KANKAKEE, IL 60901-3694
(815) 936-3250
(815) 936-3253
Mailing address
455 W COURT ST, SUITE 302, KANKAKEE, IL 60901-3679
(815) 936-3250
(815) 936-3253
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
036073974
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB9171
RAILROAD MEDICARE
IL
01
—
DC7793
RAILROAD MEDICARE
IL
Enumeration date
04/03/2006
Last updated
03/17/2018
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