Basic Information
| Provider Information | |||||||||
| NPI: | 1124256136 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | INDYK | ||||||||
| FirstName: | SABRINA | ||||||||
| MiddleName: | ANTONINA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 REMINGTON BLVD STE 100 | ||||||||
| Address2: | |||||||||
| City: | BOLINGBROOK | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604404707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | |||||||||
| FaxNumber: | 6309142469 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 N RIVER RD STE 110 | ||||||||
| Address2: | |||||||||
| City: | DES PLAINES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600161272 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473428956 | ||||||||
| FaxNumber: | 8473428958 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2009 | ||||||||
| LastUpdateDate: | 03/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 125056978 | IL | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 036128798 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.