MEDICARE: NORTHERN MEDICINE, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician		IL

General Provider Information

NPI Number	:	1497790240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN MEDICINE, P.C.

Provider Business Mailing Address
First Line	:	1528 MAPLE AVE
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-5475
Country	:	US
Telephone Number	:	847-830-7651
Fax Number	:

Provider Business Practice Location Address
First Line	:	1528 MAPLE AVE
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-5475
Country	:	US
Telephone Number	:	847-830-7651
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN OWNER OF PRACTICE
Name	:	DR. ALARMELU SAMBANDAM
Credential	:	D.O.
Telephone Number	:	847-830-7651

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	08/22/2020

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Directions to “NORTHERN MEDICINE, P.C. ” Practice Location

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