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Individual
MRS. SANJUKTA MITRA
Active
Individual
MRS. SANJUKTA MITRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036062584
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110312
CIGNA
IL
05
—
0360625841
—
IL
01
—
05600261
BLUE CROSS BLUE SHIELD
IL
01
—
0584515
AETNA
IL
01
—
P00082299
RAILROAD MEDICARE
IL
Enumeration date
11/27/2006
Last updated
05/08/2008
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