Samaraweera, Mohin Tissa

Samaraweera, Mohin Tissa is an individual health care provider with primary practice located at 24016 W Main Street , Plainfield IL 60544. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Samaraweera, Mohin Tissa can be contacted via phone (815) 436-7303.

Contact Information

Primary practice address
24016 W Main Street Plainfield IL 60544
Phone: (815) 436-7303
Fax: (815) 609-7980
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36048836 Illinois

Profile Details

NPI number 1295896173
LBN Legal business name Samaraweera, Mohin Tissa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Dec 22nd, 2009 - 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 1295896173 NPPES
Illinois MEDICAID 03L048836
Illinois Other 9900490

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