Individual
DR. BASAVA ANCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5145 N CALIFORNIA AVE, ICU, CHICAGO, IL 60625-3661
(773) 878-8200
Mailing address
2740 W FOSTER AVE, LL7, CHICAGO, IL 60625-3500
(773) 878-8200
(773) 293-4197
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036085594
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085594
—
IL
01
—
K26778
PTAN
—
Enumeration date
05/26/2006
Last updated
10/30/2020
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