Tejal R Modi (NPI# 1639370794, PAC ID# 3577792811) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1639370794 |
| PAC ID by PECOS | 3577792811 |
| Professional Enrollment ID | I20140206001239 |
| Full Name | Tejal R Modi |
| Organization Legal Name | CRYSTAL LAKE IMMEDIATE CARE PHYSICIANS LTD. |
| Address |
525 E Congress Pkwy Suite 100 Crystal Lake IL 60014-6271 |
| Phone Number | 8154798020 |
| Gender | F |
| Graduation Year | 2006 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 2961783139 |
| Number of Group Practice Members | 16 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140291 | ADVOCATE GOOD SHEPHERD HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6271 | 8154798020 | CRYSTAL LAKE IMMEDIATE CARE PHYSICIANS LTD. |
| Organization Legal Name | CRYSTAL LAKE IMMEDIATE CARE PHYSICIANS LTD. |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Makiko Ogino Mcelligott | Physician Assistant | Crystal Lake Immediate Care Physicians Ltd. | 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6271 |
| Nadir Mallick | Family Medicine | Crystal Lake Immediate Care Physicians Ltd. | 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6271 |
| Jennifer Nieves | Nurse Practitioner | Crystal Lake Immediate Care Physicians Ltd. | 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6271 |
| Rahul R Modi | Internal Medicine | Crystal Lake Immediate Care Physicians Ltd. | 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6271 |
| Fahad Karim Mustafa | Family Medicine | Crystal Lake Immediate Care Physicians Ltd. | 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6271 |
| Nancy Maria Mule | Physician Assistant | Crystal Lake Immediate Care Physicians Ltd. | 525 E Congress Pkwy, Crystal Lake, IL 60014-6271 |
| Street Address |
525 E CONGRESS PKWY SUITE 100 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip | 60014-6271 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jill M Behm | Nurse Practitioner | Advocate Health and Hospitals Corporation | 525 E Congress Pkwy, Crystal Lake, IL 60014-6258 |
| Makiko Ogino Mcelligott | Physician Assistant | Crystal Lake Immediate Care Physicians Ltd. | 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6271 |
| Julie R Favia | Obstetrics/gynecology | Advocate Health and Hospitals Corporation | 525 E Congress Pkwy, Crystal Lake, IL 60014-6258 |
| Anthony Weston | Family Medicine | Advocate Health and Hospitals Corporation | 525 E Congress Pkwy, Crystal Lake, IL 60014-6258 |
| Guy Steinberg | Obstetrics/gynecology | Advocate Health and Hospitals Corporation | 525 E Congress Pkwy, Crystal Lake, IL 60014-6258 |
| Nadir Mallick | Family Medicine | Crystal Lake Immediate Care Physicians Ltd. | 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6271 |
| Suwan Mehra | Obstetrics/gynecology | Advocate Health and Hospitals Corporation | 525 E Congress Pkwy, Crystal Lake, IL 60014-6258 |
| Jennifer Nieves | Nurse Practitioner | Crystal Lake Immediate Care Physicians Ltd. | 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6271 |
| Rahul R Modi | Internal Medicine | Crystal Lake Immediate Care Physicians Ltd. | 525 E Congress Pkwy, Suite 100, Crystal Lake, IL 60014-6271 |
| Carol A Kotzan | Internal Medicine | 525 E Congress Pkwy, Suite 250, Crystal Lake, IL 60014-6258 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Socha | Chiropractic | 435 Angela Ln, Suite 19, Crystal Lake, IL 60014-1074 | |
| Mark D Lagerkvist | Chiropractic | Chiro One Wellness Center of Crystal Lake Sc | 435 Angela Ln, Suite 19, Crystal Lake, IL 60014-1074 |
| Michael T Burns | Psychologist, Clinical | 610 Crystal Point Dr, Suite 3, Crystal Lake, IL 60014-1400 | |
| Kenneth E Heinrichs | Psychologist, Clinical | 755 E Mcardle Dr, Suite E, Crystal Lake, IL 60014-1717 | |
| Katherine A Galias | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Susan G Swanson | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Christy A Benton | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Roseann C Iverson | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Cynthia G Macdonald | Nurse Practitioner | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Michael S Lesser | Family Medicine | Family Medicine for Mchenry County | 1095 Pingree Rd, Suite 108, Crystal Lake, IL 60014-1726 |
| Find all physicians in zip 60014 | |||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | CRYSTAL LAKE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Tejal R Modi.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.