MEDICARE: MS. SAPANA H RANA D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036118973	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1144214644	OTHER	IL	FACILITY NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235321704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SAPANA H RANA D.O.

Provider Business Mailing Address
First Line	:	10961 S KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60655-2219
Country	:	US
Telephone Number	:	773-239-9100
Fax Number	:	773-239-9102

Provider Business Practice Location Address
First Line	:	10961 S KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60655-2219
Country	:	US
Telephone Number	:	773-239-9100
Fax Number	:	773-239-9102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2007
Last Update Date	:	04/01/2008

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