Mohin T Samaraweera MD SC Plainfield Medical Center

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

36048836 Issued in IL

Legal business name

MOHIN T SAMARAWEERA MD SC PLAINFIELD MEDICAL CENTER

Practice address

24016 W Main St
Plainfield, IL 60544-2232

Phone

(815) 436-7303

Fax

(815) 609-7980

NPI assigned

Mar 16, 2007

Organization subpart

No

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

Authorized official

Name

Mohin Tissa Samaraweera, MD

Title

Director

Phone

(815) 436-7303

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1821112046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24016 W MAIN ST",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605442232",
            "telephone_number": "815-436-7303",
            "fax_number": "815-609-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24016 W MAIN ST",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605442232",
            "telephone_number": "815-436-7303",
            "fax_number": "815-609-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHIN T SAMARAWEERA MD SC PLAINFIELD MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "SAMARAWEERA",
        "authorized_official_first_name": "MOHIN",
        "authorized_official_middle_name": "TISSA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "815-436-7303",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "36048836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF IL",
            "identifier": "9900490",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Plainfield, IL
• Providers in Plainfield, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.