| Organization Name: | MOHIN T SAMARAWEERA MD SC PLAINFIELD MEDICAL CENTER |
| NPI Number: | 1821112046 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MOHIN TISSA SAMARAWEERA (DIRECTOR) |
| Mailing Address: | 24016 W Main St Plainfield |
| State: | IL US |
| Postal Code: | 605442232 |
| Phone Number: | 8154367303 |
| Fax Number: | 8156097980 |
| NPI Enumeration Date: | 03/16/2007 |
| NPI Last Update Date: | 09/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 36048836 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |