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Individual

SANMIT KUMAR BASU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5841 S MARYLAND AVE # MC4051, CHICAGO, IL 60637-1443
(773) 702-1061
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
036122876
IL
2080P0202X
Pediatric Cardiology Physician
35123781
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0104564
OH
Enumeration date
08/06/2008
Last updated
10/31/2018
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