Individual
SEJAL A THAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3231 EUCLID AVE, SUITE 405, BERWYN, IL 60402-3471
(708) 783-2644
Mailing address
3231 EUCLID AVE, SUITE 405, BERWYN, IL 60402-3471
(708) 783-2644
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036123694
IL
207RP1001X
Pulmonary Disease Physician
Primary
036123694
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123694
—
IL
01
—
050483739
UNITED HEALTH CARE
RI
01
—
202143
MEDICARE PTAN
IL
01
—
29951-4
BCBS OF RI
RI
01
—
31388
NEIGHBORHOOD HEALTH PLAN
RI
01
—
3238831
CIGNA
RI
01
—
412690
BLUE CHIP
RI
01
—
478831
TUFTS HEALTH PLAN
RI
05
—
7057835
—
RI
01
—
709003710
MEDICARE GROUP
RI
01
—
AA41888
HARVARD HEALTH PLAN
RI
Enumeration date
07/18/2005
Last updated
04/29/2013
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