Penmetcha, Sanjay

Penmetcha, Sanjay is an individual health care provider with primary practice located at 30 E 15Th St , Chicago Heights IL 60411-3459. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Penmetcha, Sanjay can be contacted via phone (708) 756-5454.

Contact Information

Primary practice address
30 E 15Th St Chicago Heights IL 60411-3459
Phone: (708) 756-5454
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036-097423 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036097423 Illinois

Profile Details

NPI number 1568489185
LBN Legal business name Penmetcha, Sanjay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Jun 18th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568489185 NPPES
Illinois MEDICAID 036097423

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