Provider Demographics
NPI:1467689281
Name:TOTONCHI, SAMER (DO)
Entity Type:Individual
Prefix:
First Name:SAMER
Middle Name:
Last Name:TOTONCHI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3231 EUCLID AVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3471
Mailing Address - Country:US
Mailing Address - Phone:708-783-0700
Mailing Address - Fax:
Practice Address - Street 1:3231 EUCLID AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3471
Practice Address - Country:US
Practice Address - Phone:708-783-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018253208800000X
IL036141865208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICB9133OtherMEDICARE RAILROAD
MIP01593351OtherRAILROAD MEDICARE
MI137656OtherMERIDIAN
MI0E06273072Medicare PIN
MI0246721OtherTOTAL HEALTH CARE