MB Medical PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MB MEDICAL PLLC

Practice address

229 W Grand Ave Suite
Suite S
Bensenville, IL 60106-6010

Phone

(630) 235-6868

Fax

(630) 235-6868

NPI assigned

Nov 10, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Krish Venoo, MDNPI 1487829834

Title

Owner

Phone

(630) 235-6868

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• MB Medical PLLC

  • Clinical Medical Laboratory
  • Bensenville, IL
  • NPI 1770263543

  8628475761

  Same PAC ID

Tax ID family

MB Medical PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• MB Medical PLLC

  • Clinical Medical Laboratory
  • Bensenville, IL
  • NPI 1770263543
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Krish George Venoo, M.D.

  • Surgery Physician
  • Chicago, IL
  • NPI 1487829834
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1093317414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 W GRAND AVE STE S",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601063365",
            "telephone_number": "630-235-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W GRAND AVE SUITE",
            "address_2": "SUITE S",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601066010",
            "telephone_number": "630-235-6868",
            "fax_number": "630-235-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MB MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-10",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "VENOO",
        "authorized_official_first_name": "KRISH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-235-6868",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mbmedical1@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "information",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "information",
            "address_1": "229 W Grand Ave Suite",
            "address_2": "suite s",
            "city": "Bensenville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601066010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natalia Cristina Martin, H.I.S
• Tomy Mathew
• Smitha Elizabeth Mathews, PT
• Lizeth Mauro, APRN, FNP-BC
• Gretchen Lynn Maynard, O.D.
• MB Medical PLLC
• Melanie McCarthy, OTRL
• Patrick Meade
• Thomas Meade, PHARMD
• Suraj Mehta, PHARMD

• Internal Medicine Physician in Bensenville, IL
• Providers in Bensenville, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.