Provider Demographics
NPI:1861545139
Name:DAS, AJAY KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:AJAY
Middle Name:KUMAR
Last Name:DAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5445 N SHERIDAN RD
Mailing Address - Street 2:UNIT 1015
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1957
Mailing Address - Country:US
Mailing Address - Phone:773-350-5306
Mailing Address - Fax:773-506-7581
Practice Address - Street 1:5445 N SHERIDAN RD
Practice Address - Street 2:UNIT 1015
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1957
Practice Address - Country:US
Practice Address - Phone:773-350-5306
Practice Address - Fax:773-506-7581
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2014-08-13
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Provider Licenses
StateLicense IDTaxonomies
IL036046872207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD12589Medicare UPIN