Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 036.122098 | IL |
N | 207QA0401X | Family Doctor - Addiction Medicine | 036.122098 | IL |
N | 207QA0505X | Family Doctor - Adult Medicine | 036.122098 | IL |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 036.122098 | IL |
N | 207R00000X | Internist | 036.122098 | IL |
N | 111NI0900X | Internist | 036.122098 | IL |
N | 207RA0401X | Internist - Addiction Medicine | 036.122098 | IL |
N | 208200000X | Surgeon | 036.122098 | IL |
N | 208600000X | Surgeon | 036.122098 | IL |
N | 208D00000X | General Practice Physician | 036.122098 | IL |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 036.122098 | IL |
NPI | 1508907122 |
---|---|
Provider Name | Narayanappa Sathish Babu |
First Address | Bolingbrook, IL 60490-2020 |
Second Address | Darien, IL 60561-1510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 26/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
213215007 | INDIVIDUAL PTAN (01) | IL |
60025-30 | (05) | IL |
60202-01 | (05) | IL |
IL 2437002 | INDIVIDUAL PTAN (01) | IL |