Healthcare Provider Details

I. General information

NPI: 1174741805
Provider Name (Legal Business Name): SANATH KUMAR, MD., LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 12/23/2021
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9445 W 144TH PL
ORLAND PARK IL
60462-2543
US

IV. Provider business mailing address

9445 W 144TH PL
ORLAND PARK IL
60462-2543
US

V. Phone/Fax

Practice location:
  • Phone: 708-460-8081
  • Fax: 708-460-8089
Mailing address:
  • Phone: 708-460-8081
  • Fax: 708-460-8089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SANATH KUMAR
Title or Position: SURGEON
Credential: MD
Phone: 708-460-8081