Healthcare Provider Details

I. General information

NPI: 1013189281
Provider Name (Legal Business Name): DR. KAMEL SADAT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2008
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 N LAKE SHORE DR APT 4B
CHICAGO IL
60657-4859
US

IV. Provider business mailing address

3180 N LAKE SHORE DR APT 4B
CHICAGO IL
60657-4859
US

V. Phone/Fax

Practice location:
  • Phone: 773-759-2408
  • Fax:
Mailing address:
  • Phone: 773-759-2408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberQ2072
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01079402A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number30987
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number01079402A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number01079402A
License Number StateIN
# 6
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number01079402A
License Number StateIN
# 7
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number01079402A
License Number StateIN
# 8
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036.124018
License Number StateIL
# 9
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number01079402A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: