Individual ProviderJayesh ThakkarFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address2015 Dean St, #2, St Charles, IL 60174-1577(630) 584-2400PECOS EnrollmentBased on the most recent information from CMS, provider Jayesh Thakkar is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1780778977Provider TypeIndividualFull NameThakkar, JayeshTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date10/3/2006Last Updated3/5/2014Contact InformationPractice LocationPractice Address2015 Dean St, #2, St Charles, IL 60174-1577Phone(630) 584-2400Fax(630) 584-2404Mailing LocationMailing Address2015 Dean St, #2, St Charles, IL 60174-1577Phone(630) 584-2400Fax(630) 584-2404Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense036100883IllinoisProvider IdentifiersIDDescriptionIssuerID04532098DescriptionOtherIssuerBCBSIllinoisID036100883DescriptionMedicaidIssuerUnlistedIllinois