Healthcare Provider Details

I. General information

NPI: 1275503211
Provider Name (Legal Business Name): SATYA AHUJA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6535 S WESTERN AVE
CHICAGO IL
60636-2410
US

IV. Provider business mailing address

210 S DESPLAINES ST
CHICAGO IL
60661-5500
US

V. Phone/Fax

Practice location:
  • Phone: 312-654-2700
  • Fax: 312-654-9930
Mailing address:
  • Phone: 312-654-2700
  • Fax: 312-654-9930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number036046612
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: