SMB Medical Group de, P.a.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SMB MEDICAL GROUP DE, P.A.

Practice address

1S376 Summit Ave BLDG C
Oakbrook Terrace, IL 60181-3985

Phone

(415) 835-4794

NPI assigned

May 31, 2024

Last updated

May 31, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandeep Khosla, MD

Title

President

Phone

(415) 835-4794

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1912747437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1S376 SUMMIT AVE BLDG C",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1S376 SUMMIT AVE BLDG C",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813985",
            "telephone_number": "415-835-4794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMB MEDICAL GROUP DE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "KHOSLA",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-835-4794",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Oakbrook Terrace, IL
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• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.