Physician Compare National (NPI:1629015292)

HEALTHCARE PROVIDER: MRUNAL PANCHAL MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1629015292
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688641863
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100614000712
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PANCHAL
	Individual professional last name
Provider First Name	MRUNAL
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
	Individual professional's medical school
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	RHEUMATOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	RHEUMATOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	800 BIESTERFIELD RD
	Group Practice or individual's line 1 address
City	ELK GROVE VILLAGE
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	600073397
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140258
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ALEXIAN BROTHERS MEDICAL CENTER 1
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140252
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NORTHWEST COMMUNITY HOSPITAL 1
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y