=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265616411
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | U K SINHA, M.D., S.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/24/2007
-----------------------------------------------------
Last Update Date | 05/12/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 S PARK ST
-----------------------------------------------------
City | STREATOR
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61364-4448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-672-2829
-----------------------------------------------------
Fax | 815-672-9225
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 205 S PARK ST
-----------------------------------------------------
City | STREATOR
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61364-4448
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-672-2829
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. UPENDRA K SINHA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 815-672-2829
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 036059506
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------