Basic Information
| Provider Information | |||||||||
| NPI: | 1336281575 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SANI | ||||||||
| FirstName: | SEPEHR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2040 OGDEN AVE | ||||||||
| Address2: | SUITE 313 | ||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605047222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6304992404 | ||||||||
| FaxNumber: | 6304992399 | ||||||||
| Practice Location | |||||||||
| Address1: | 2040 OGDEN AVE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | AURORA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605047222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6309786770 | ||||||||
| FaxNumber: | 6309786773 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2007 | ||||||||
| LastUpdateDate: | 07/16/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | A98611 | CA | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 036-110500 | IL | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
No ID Information.