Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 036087786 | IL |
NPI | 1336211630 |
---|---|
Provider Name | Sai S Ramasastry |
First Address | Chicago, IL 60612-4325 |
Second Address | Chicago, IL 60612-7232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 24/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B41879 | (02) |