Healthcare Provider Details

I. General information

NPI: 1487825824
Provider Name (Legal Business Name): SAROJ K VERMA MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 S EWING AVE
CHICAGO IL
60617-6606
US

IV. Provider business mailing address

10701 S EWING AVE
CHICAGO IL
60617-6606
US

V. Phone/Fax

Practice location:
  • Phone: 773-721-4900
  • Fax: 773-721-8963
Mailing address:
  • Phone: 773-721-4900
  • Fax: 773-721-8963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. SAROJ K VERMA
Title or Position: OWNER
Credential: MD SC
Phone: 773-721-4900