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General NPI Number Information
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NPI Number | 1558526566
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Entity Type | Individual
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Provider Name | ROBERT SAKULANDA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/20/2008
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 5306 N CUMBERLAND AVE APT. 214
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City | CHICAGO
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State | IL
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Zip | 60656-1464
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Country | US
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Telephone | 773-628-7336
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Fax |
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Provider Business Mailing Address
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Address Line | 2115 RIVER FALLS DR
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City | ROSWELL
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State | GA
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Zip | 30076-5122
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Country | US
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Telephone | 317-414-9712
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 61649
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036.119229
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License Number State | IL
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