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Organization

PINAKINPRASAD DAVE, MD, SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PINAKINPRASAD DAVE M.D. (PRESIDENT)
(708) 895-6439
Entity
Organization

Contact information

Practice address
1851 SIBLEY BLVD, CALUMET CITY, IL 60409-2252
(708) 868-2300
(708) 868-2304
Mailing address
1940 E 170TH PL, SOUTH HOLLAND, IL 60473-3703
(708) 895-6439

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036055316
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036055316
IL
Enumeration date
02/12/2010
Last updated
02/12/2010
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