Provider Demographics
NPI:1457590457
Name:BEDIKIAN, SARKIS MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:SARKIS
Middle Name:MICHAEL
Last Name:BEDIKIAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10330 S ROBERTS RD
Mailing Address - Street 2:UNIT 911
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-1971
Mailing Address - Country:US
Mailing Address - Phone:630-965-8787
Mailing Address - Fax:
Practice Address - Street 1:10330 S ROBERTS RD
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1971
Practice Address - Country:US
Practice Address - Phone:708-237-7200
Practice Address - Fax:708-237-7201
Is Sole Proprietor?:No
Enumeration Date:2009-02-13
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121348207XS0114X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400202371OtherMEDICARE PTAN
IL036121348Medicaid
IL215958120OtherMEDICARE PTAN
ILF400202372OtherMEDICARE PTAN