Organization
DATTA SAMBARE M D S C
Active
Parent organization
DATTA SAMBARE M D S C
Other names
Madison Parkside Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
DATTA SAMBARE M D S C
Authorized official
DATTA SAMBARE M.D. (PRESIDENT)
(773) 379-2304
Entity
Organization
Contact information
Practice address
5650 W MADISON ST, CHICAGO, IL 60644-3939
(773) 379-2304
Mailing address
PO BOX 215, WESTMONT, IL 60559-0215
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/22/2006
Last updated
06/03/2009
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