Individual
DIPALI BANERJEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2875 W 19TH ST, CHICAGO, IL 60623-3501
(773) 665-3045
Mailing address
PO BOX 2486, INDIANAPOLIS, IN 46206-2486
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036058352
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621061
BCBS PATHOLOGY CHP
IL
01
—
01636148
BCBS PATHOLOGY SERVICE IL
IL
05
—
036058352
—
IL
01
—
132302200
DEPT OF LABOR
—
01
—
220033246
RAILROAD MEDICARE-PATHOLOGY CHP
IL
01
—
364125320002
CHAMPUS
—
01
—
P00332720
RAILROAD MEDICARE- PSIL
IL
Enumeration date
09/14/2006
Last updated
11/03/2010
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