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General NPI Number Information
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NPI Number | 1801991443
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Entity Type | Organization
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Legal Business Name | RAVINDRANATH K SANSGUIRI MD SC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 2875 W 19TH ST
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City | CHICAGO
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State | IL
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Zip | 60623-3501
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Country | US
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Telephone | 773-484-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 8180 LAKE RIDGE DR
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City | BURR RIDGE
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State | IL
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Zip | 60527-5975
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Country | US
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Telephone | 630-323-2010
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Fax |
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Authorized Official
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Title or Position | MD
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Name | RAVINDRANATH K SANSGUIRI
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Credential | MD
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Telephone | 630-323-2010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036048838
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License Number State | IL
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