Healthcare Provider Details

I. General information

NPI: 1295930535
Provider Name (Legal Business Name): SEERAS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 01/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6842 CERMAK RD
BERWYN IL
60402-2240
US

IV. Provider business mailing address

80 BURR RIDGE PKWY PMB 146
BURR RIDGE IL
60527-0832
US

V. Phone/Fax

Practice location:
  • Phone: 708-788-2038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateIL

VIII. Authorized Official

Name: RAMESH SEERAS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 708-788-2038