Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 036132301 | IL |
N | 2081P2900X | Pain Medicine | FB3802635 | IL |
NPI | 1326214651 |
---|---|
Provider Name | Dr. Sachin Kumar Bansal |
First Address | Aurora, IL 60504-7597 |
Second Address | Aurora, IL 60504-7597 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2008 |
Last Update Date | 06/04/2020 |