Basic Information
| Provider Information | |||||||||
| NPI: | 1568881225 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PLAMOOTTIL | ||||||||
| FirstName: | CHERIAN | ||||||||
| MiddleName: | ISSAC | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1040 SIERRA DR STE 400 | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461437241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3175284248 | ||||||||
| FaxNumber: | 3178658314 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 DIXIE HWY | ||||||||
| Address2: | |||||||||
| City: | CHICAGO HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604111696 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7087557069 | ||||||||
| FaxNumber: | 7087557640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2014 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | 036143413 | IL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.