# BHANU P SANKINENI LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972048429
- **Authorized official:** BHANU P SANKINENI MD (SOLE OWNER)
- **Authorized official phone:** (608) 561-6644

## Contact information

- **Practice address:** 11101 N SHERMAN RD, EDGERTON, WI 53534-9002
- **Practice address phone:** (702) 453-3799
- **Practice address fax:** (702) 453-5741
- **Mailing address:** PO BOX 4071, BARRINGTON, IL 60011-4071
- **Mailing address phone:** (702) 453-3799
- **Mailing address fax:** (702) 453-5741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 64184-20 | WI | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/19/2016
- **Last updated:** 10/29/2022