Provider Demographics
NPI:1336463413
Name:SUNITA TALWAR MDSC
Entity Type:Organization
Organization Name:SUNITA TALWAR MDSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNITA
Authorized Official - Middle Name:
Authorized Official - Last Name:TALWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-755-3252
Mailing Address - Street 1:1585 BARRINGTON RD STE 306
Mailing Address - Street 2:ST ALEXIS MEDICAL CENTER
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5019
Mailing Address - Country:US
Mailing Address - Phone:847-755-3252
Mailing Address - Fax:847-755-3250
Practice Address - Street 1:1585 BARRINGTON RD STE 306
Practice Address - Street 2:ST ALEXIS MEDICAL CENTER
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5019
Practice Address - Country:US
Practice Address - Phone:847-755-3252
Practice Address - Fax:847-755-3250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036070075207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036070075Medicaid
IL036070075Medicaid