Healthcare Provider Details

I. General information

NPI: 1962760314
Provider Name (Legal Business Name): MAKI SATO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2012
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 S ROSELLE RD
SCHAUMBURG IL
60193-2925
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-985-0600
  • Fax:
Mailing address:
  • Phone: 847-982-6715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036138300
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: