MEDICARE: SARITHA VANKANA MDSC

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
1	207R00000X	Internal Medicine Physician	036098715	IL

Other Identifiers

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

General Provider Information

NPI Number	:	1285951335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARITHA VANKANA MDSC

Provider Business Mailing Address
First Line	:	6529 MIDDLECOFF CT
Second Line	:
City	:	WOODRIDGE
State	:	IL
Zip	:	60517-1487
Country	:	US
Telephone Number	:	630-886-3209
Fax Number	:

Provider Business Practice Location Address
First Line	:	1516 MADISON ST
Second Line	:
City	:	MAYWOOD
State	:	IL
Zip	:	60153-1824
Country	:	US
Telephone Number	:	708-343-6450
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SARITHA VANKANA
Credential	:	MD
Telephone Number	:	630-886-3209

Provider Enumeration Date	:	04/29/2010
Last Update Date	:	05/07/2025

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