1760404958 NPI number — DR. SATNAM K PAPA M.D.

Table of content: DR. SATNAM K PAPA M.D. (NPI 1760404958)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760404958 NPI number — DR. SATNAM K PAPA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAPA
Provider First Name:
SATNAM
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1760404958
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5 METTAWA LANE
Provider Second Line Business Mailing Address:
N500
Provider Business Mailing Address City Name:
RIVERWOODS
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60015-3551
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-455-4780
Provider Business Mailing Address Fax Number:
414-475-2936

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 METTAWA LANE
Provider Second Line Business Practice Location Address:
OAMRI OF OAK BROOK LLC
Provider Business Practice Location Address City Name:
RIVERWOODS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60015-3551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-850-8501
Provider Business Practice Location Address Fax Number:
630-850-9872
Provider Enumeration Date:
07/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  036111732 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 036111732 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".