Individual
DR. POONAM PANKAJ THAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7447 W TALCOTT AVE, SUITE 182, CHICAGO, IL 60631-3745
(773) 792-5155
(773) 594-7975
Mailing address
7447 W TALCOTT AVE, SUITE 182, CHICAGO, IL 60631-3745
(773) 792-5155
(773) 594-7975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-116808
IL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036-116808
IL
Other
Enumeration date
04/16/2008
Last updated
03/24/2021
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