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NPI Code Detail

MEDICARE: SATYA M MISHRA MD

MEDICARE: SATYA M MISHRA 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
1207RG0100XGastroenterology Physician036-106636IL

General Provider Information

NPI Number : 1346245321
Entity Type Code : Individual
Provider Name (Legal Business Name) : SATYA M MISHRA MD
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 17850 KEDZIE AVE STE 3500
Second Line :
City : HAZEL CREST
State : IL
Zip : 60429-2082
Country : US
Telephone Number : 708-957-4011
Fax Number : 708-957-4013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2005
Last Update Date : 01/31/2025

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Directions to “ SATYA M MISHRA MD” Practice Location

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