Provider Demographics
NPI:1558785964
Name:ATT MEDICAL LTD
Entity Type:Organization
Organization Name:ATT MEDICAL LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:PENMETCHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-927-0684
Mailing Address - Street 1:7810 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-8011
Mailing Address - Country:US
Mailing Address - Phone:312-927-0684
Mailing Address - Fax:630-952-1447
Practice Address - Street 1:7810 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-8011
Practice Address - Country:US
Practice Address - Phone:312-927-0684
Practice Address - Fax:630-952-1447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-06
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH35120Medicare UPIN