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Individual

DR. ELIZABETH ELLEN SENGUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2900 N LAKE SHORE DR, CHICAGO, IL 60657-5640
(773) 665-3679
(773) 665-3612
Mailing address
2900 N LAKE SHORE DR, CHICAGO, IL 60657-5640
(773) 665-3679
(773) 665-3612

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036072945
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000383415
ANTHEM BCBS
IN
05
036072945
IL
05
100378240
IN
01
P00296508
RAILROAD MEDICARE
Enumeration date
01/23/2006
Last updated
02/08/2016
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