Provider Demographics
NPI:1710058763
Name:METRO FAMILY CARE
Entity Type:Organization
Organization Name:METRO FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SURINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHAJPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-425-9096
Mailing Address - Street 1:3554 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2107
Mailing Address - Country:US
Mailing Address - Phone:708-499-0900
Mailing Address - Fax:
Practice Address - Street 1:3554 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2107
Practice Address - Country:US
Practice Address - Phone:708-499-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC44808Medicare UPIN