1013009653 NPI number — MR. PRADIP SETHI MD

Table of content: MR. PRADIP SETHI MD (NPI 1013009653)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013009653 NPI number — MR. PRADIP SETHI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SETHI
Provider First Name:
PRADIP
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1013009653
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 NORTH AIRLITE ST
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
ELGIN
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60123-4965
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-695-0985
Provider Business Mailing Address Fax Number:
847-695-4373

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 NORTH AIRLITE ST
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
ELGIN
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60123-4965
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-695-0985
Provider Business Practice Location Address Fax Number:
847-695-4373
Provider Enumeration Date:
09/29/2006

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: 2084S0012X , with the licence number:  036055338 , 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: 4901097 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: P00319590 . This is a "MEDICARE RAILROAD CARRIER" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com