Datta Sambare M D S C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

DATTA SAMBARE M D S C

Doing business as

Brookville Medical Center

Practice address

730 S Weber Rd
Unit G
Bolingbrook, IL 60490-5472

Phone

(630) 378-2000

NPI assigned

Jul 24, 2006

Last updated

Mar 29, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

DATTA SAMBARE M D S CAs reported in NPPES

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

Authorized official

Name

Datta Sambare, M.D.NPI 1619911211

Title

President

Phone

(630) 378-2000

Specialties & licenses 2

Addresses

Other names 1

• Brookville Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Datta Sambare M D S C

  dba Madison Parkside Medical Center

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1821034224

  O20041018000376

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Datta Sambare M D S C

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Datta Sambare, M.D.

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1619911211
  Medicare reassignment Care Compare group NPD Authorized official
• Varsha Sambare, M.D.

  • Family Medicine Physician
  • Bolingbrook, IL
  • NPI 1497775233
  Medicare reassignment Care Compare group NPD
• Mohammed Murtaza Arain, M.D.

  • Specialist
  • Bolingbrook, IL
  • NPI 1992781108
  NPD (past)
• Rama Lakshmanarao Theegala, M.D

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1780973453
  NPD (past)
• Laarni May G Moreno, M.D.

  • Hospitalist Physician
  • Elkhart, IN
  • NPI 1801840954

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1780606566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605590215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 S WEBER RD",
            "address_2": "UNIT G",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604905472",
            "telephone_number": "630-378-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DATTA SAMBARE M D S C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DATTA SAMBARE M D S C",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "SAMBARE",
        "authorized_official_first_name": "DATTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-378-2000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookville Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Audre A Daniels, RPH
• Julie A Danker, MSW LCSW
• Danzell Wellness Group, PLLC
• Cindy Crystal Danzell, MS, LCPC, NCC, PEL
• Dark Star Transit Inc.
• Ramadevi Davarapalli, MD
• Katrina Morta David, OTRL
• Sarah Rebecca Davies, MS, ATC/L
• Audrey R. Davis, ED.D., MSW, LCSW
• Susan M Davis, ND, FNP-BC

• Family Medicine Physician in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.