Individual
SANJEEV KUMAR PRADHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-120607
IL
2086S0129X
Vascular Surgery Physician
Primary
036-120607
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618941
BCBS
IL
05
—
036120607
—
IL
05
—
200913040B
—
IN
Enumeration date
05/01/2008
Last updated
09/04/2024
Update your record
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