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NPI Code Detail

MEDICARE: DIPALI BANERJEE M.D.

MEDICARE: DIPALI BANERJEE M.D.
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
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician036058352IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00332720OTHERILRAILROAD MEDICARE- PSIL
6220033246OTHERILRAILROAD MEDICARE-PATHOLOGY CHP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2364125320002OTHERCHAMPUS
301621061OTHERILBCBS PATHOLOGY CHP
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
501636148OTHERILBCBS PATHOLOGY SERVICE IL
7132302200OTHERDEPT OF LABOR

General Provider Information

NPI Number : 1780789784
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIPALI BANERJEE M.D.
Provider Business Mailing Address
First Line : PO BOX 2486
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-2486
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2875 W 19TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60623-3501
Country : US
Telephone Number : 773-665-3045
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 11/03/2010

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Directions to “ DIPALI BANERJEE M.D.” Practice Location

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