Healthcare Provider Details

I. General information

NPI: 1528285566
Provider Name (Legal Business Name): MARY CATHERINE BARSANTI-SEKHAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. MARY CATHERINE BARSANTI

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 10/25/2020
Certification Date: 10/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2160 S 1ST AVE
MAYWOOD IL
60153-3328
US

IV. Provider business mailing address

2160 S 1ST AVE
MAYWOOD IL
60153-3328
US

V. Phone/Fax

Practice location:
  • Phone: 708-216-9000
  • Fax:
Mailing address:
  • Phone: 708-216-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2006016359
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number2006016359
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2006016359
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License Number2006016359
License Number StateMO
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036134317
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: