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NPI Code Detail

MEDICARE: DR. PRICHA SATTAYATAM MD

MEDICARE: DR. PRICHA SATTAYATAM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician036048608IL
2207Q00000XFamily Medicine Physician036048608IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205814100
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRICHA SATTAYATAM MD
Provider Business Mailing Address
First Line : 5204 DIXON DR
Second Line :
City : GODFREY
State : IL
Zip : 62035-1420
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1200 E TREMONT ST
Second Line :
City : HILLSBORO
State : IL
Zip : 62049-1912
Country : US
Telephone Number : 217-532-6222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2006
Last Update Date : 03/31/2008

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Directions to “ DR. PRICHA SATTAYATAM MD” Practice Location

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