Organization
SARAH DUTTA, OB-GYN, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH DUTTA MD (OWNER/PRESIDENT)
(309) 661-0406
Entity
Organization
Contact information
Practice address
107 N REGENCY DR, SUITE 3, BLOOMINGTON, IL 61701-3505
(309) 661-0406
(309) 661-6446
Mailing address
107 N REGENCY DR, SUITE 3, BLOOMINGTON, IL 61701-3505
(309) 661-0406
(309) 661-6446
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-113555
IL
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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