Organization
KALYAN SANDESARA MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALYAN SANDESARA M.D. (PRESIDENT OF THE CORPORATION)
(773) 342-3600
Entity
Organization
Contact information
Practice address
1008 N WESTERN AVE, CHICAGO, IL 60622-3565
(773) 342-3600
(773) 342-4503
Mailing address
2410 HALINA DR E, GLENVIEW, IL 60026-1196
(773) 342-3600
(773) 342-4503
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036065899
IL
Other
Enumeration date
04/28/2009
Last updated
04/28/2009
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