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General NPI Number Information
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NPI Number | 1821473919
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Entity Type | Organization
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Legal Business Name | SAROJ K. VERMA
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Dates
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Enumeration Date | 07/30/2015
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Last Update Date | 07/30/2015
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Provider Practice Location Address
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Address Line | 10701 S EWING AVE
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City | CHICAGO
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State | IL
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Zip | 60617-6606
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Country | US
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Telephone | 773-721-4900
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Fax | 773-721-8963
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Provider Business Mailing Address
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Address Line | 10701 S EWING AVE
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City | CHICAGO
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State | IL
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Zip | 60617-6606
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARTI G GROGAN
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Credential |
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Telephone | 773-721-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 085005506
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License Number State | IL
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