Provider Demographics
NPI:1396067302
Name:SAPNA RATHI, M.D, S.C
Entity type:Organization
Organization Name:SAPNA RATHI, M.D, S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAPNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RATHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-290-0921
Mailing Address - Street 1:800 BIESTERFIELD RD
Mailing Address - Street 2:EBERLE BUILDING, SUITE 585
Mailing Address - City:ELK GROVE VLG
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3361
Mailing Address - Country:US
Mailing Address - Phone:847-290-0921
Mailing Address - Fax:847-290-0996
Practice Address - Street 1:800 BIESTERFIELD RD.
Practice Address - Street 2:EBERLE BUILDING SUITE 585
Practice Address - City:ELK GROVE
Practice Address - State:IL
Practice Address - Zip Code:60007-3362
Practice Address - Country:US
Practice Address - Phone:847-290-0921
Practice Address - Fax:847-290-0996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360879202084P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1932140472OtherNPI
IL1932140472OtherNPI