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NPI Code Detail

MEDICARE: DR. SANDEEP SAMANT MD

MEDICARE: DR. SANDEEP SAMANT 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
1207Y00000XOtolaryngology Physician036136962IL
2207YX0007XPlastic Surgery within the Head & Neck (Otolaryngology) Physician32238TN

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 : 1396701942
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SANDEEP SAMANT MD
Provider Business Mailing Address
First Line : 675 N SAINT CLAIR ST STE 15-200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-5967
Country : US
Telephone Number : 312-695-8182
Fax Number : 312-695-4303
Provider Business Practice Location Address
First Line : 675 N SAINT CLAIR ST STE 15-200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-5967
Country : US
Telephone Number : 312-695-8182
Fax Number : 312-695-4303
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2006
Last Update Date : 08/31/2020

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Directions to “ DR. SANDEEP SAMANT MD” Practice Location

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