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Individual
SANJEEV KUMAR PRADHAN
Active
Individual
SANJEEV KUMAR PRADHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-120607
IL
2086S0129X
Vascular Surgery Physician
Primary
036-120607
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618941
BCBS
IL
05
—
036120607
—
IL
05
—
200913040B
—
IN
Enumeration date
05/01/2008
Last updated
09/04/2024
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