Provider Demographics
NPI:1548383599
Name:NORTH PARK STOMACH CLINIC, LTD.
Entity Type:Organization
Organization Name:NORTH PARK STOMACH CLINIC, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:
Authorized Official - Last Name:JILHEWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-775-9500
Mailing Address - Street 1:5393 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-1251
Mailing Address - Country:US
Mailing Address - Phone:773-775-9500
Mailing Address - Fax:773-775-6975
Practice Address - Street 1:5393 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-1251
Practice Address - Country:US
Practice Address - Phone:773-775-9500
Practice Address - Fax:773-775-6975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B53868Medicare UPIN
661360Medicare ID - Type Unspecified