DR. SANJEEV KUMAR PRADHAN (NPI# 1750557658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750557658 |
| Entity Type | Individual |
| Full Name | DR. SANJEEV KUMAR PRADHAN |
| Credential | M.D. |
| Practice Address |
4400 W 95th St Suite 205 Oak Lawn IL 60453-2654 |
| Practice Telephone | 7083464040 |
| Practice Fax Number | 7083463287 |
| Mailing Telephone | 7083464040 |
| Mailing Fax Number | 7083463287 |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2014-12-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 036-120607 | IL | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
036-120607 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036120607 | 05 | |
| IN | 200913040B | 05 | |
| IL | BCBS | 01618941 | 01 |
| Street Address |
4400 W 95TH ST SUITE 205 |
| City | OAK LAWN |
| State | IL |
| Zip Code | 60453-2654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366445678 | Richard Z Belch | Specialist | 4400 W 95th St, Suite 207, Oak Lawn, IL 60453-2654 | 2005-05-31 |
| 1629683289 | Allison Gilbert | Nurse Practitioner | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2020-09-10 |
| 1164054011 | Elizabeth Gawne | Nurse Practitioner | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2020-02-09 |
| 1770128175 | Brittany Snyder | Physician Assistant | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2019-11-10 |
| 1730723446 | Christina M Tortorici | Physician Assistant | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2019-11-06 |
| 1437610805 | Duhah Hamayel | Pediatrics | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2019-03-28 |
| 1790246205 | Shawn Buxton | Pediatrics | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2019-03-27 |
| 1619456506 | Betty Joechle | Registered Nurse | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2018-08-10 |
| 1700372174 | Amy Elizabeth Calandriello | Registered Nurse | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2018-07-09 |
| 1801380563 | Corissa Nicole Culichia | Pediatrics | 4400 W 95th St, Oak Lawn, IL 60453-2654 | 2018-06-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659995231 | Natalia Zero | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Rm 131 North, Oak Lawn, IL 60453 | 2020-05-30 |
| 1114554300 | Sylvia Maria Chlebek | Student in an Organized Health Care Education/Training Program | Advocate Christ Medical Center 4440 W. 95th St., Rm 131 North, Oak Lawn, IL 60453 | 2020-03-26 |
| 1972066751 | Amanda Mroczek | Family Medicine | 9555 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-09 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1659833473 | Chelsea Sumida Gipson | Family Medicine | 9555 South 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-01 |
| 1518427418 | Robert Lindgren | Family Medicine | 9555 S. 52nd Ave., Suite F, Oak Lawn, IL 60453 | 2019-03-25 |
| 1154886695 | Stephanie Anne Comer | Social Worker | 10102 South Cicero Avenue, Suite C, Oak Lawn, IL 60453 | 2019-02-08 |
| 1700360070 | Brian L Lee | Counselor | 8938 S Ridgeland Avenue Suite 100, Oak Lawn, IL 60453 | 2018-09-21 |
| 1679085245 | International Dental of Oak Lawn | Clinic/Center | 9539 S Cicero Ave, Oak Lawn, IL 60453 | 2017-11-03 |
| 1124538301 | Kavitha Rajendran | Physician Assistant | 5851 W. 95th Street, Suite 300, Oak Lawn, IL 60453 | 2017-10-02 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265417307 | Anwar Saeed Choudhry | Surgery | 4400 W 95th Street, Suite 403, Oak Lawn, IL 60453-2661 | 2005-12-13 |
| 1134107998 | Midwest Vascular & Thoracic Surgical Specialists Ltd | Surgery | 4400 W 95th Street, Suite 403, Oak Lawn, IL 60453-2661 | 2006-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396267324 | Congress Vascular Center LLC | Surgery | 41 W Congress Pkwy Fl 1, Chicago, IL 60605-1531 | 2017-07-11 |
| 1043731300 | Elmwood Park Vascular Center LLC | Surgery | 7230 W North Ave Ste 108, Elmwood Park, IL 60707-4261 | 2017-06-27 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1992126668 | Vascular Specialists LLC | Surgery | 20060 Governors Dr Ste 102, Olympia Fields, IL 60461-1099 | 2013-12-26 |
| 1588959548 | Patrick Michael Sullivan Neville | Surgery | 4600 Memorial Dr Ste 120, Belleville, IL 62226-5359 | 2011-06-17 |
| 1235454968 | Margaret Claire Rigamer | Surgery | 1901 W Harrison St Dept Of, Chicago, IL 60612-3714 | 2010-04-06 |
| 1215251541 | John V. White, Md, LLC | Surgery | 8816 W Dempster St, Niles, IL 60714-5109 | 2010-03-15 |
| 1710212733 | Vascular Surgery and Interpretation S.c. | Surgery | 3330 W 177th St Ste 2c1, Hazel Crest, IL 60429-2184 | 2009-10-08 |
| 1538391792 | Usa Vein Clinics of Chicago LLC | Surgery | 4141 Dundee Rd, Northbrook, IL 60062-2129 | 2009-08-20 |
| 1306010731 | Tanq, Inc. | Surgery | 18510 S Marilynn Ct, Mokena, IL 60448-9517 | 2008-04-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.