Basic Information
Provider Information
NPI: 1528044757
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUMAR
FirstName: SANKAR
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 304 WAINWRIGHT DR
Address2:  
City: NORTHBROOK
State: IL
PostalCode: 600621900
CountryCode: US
TelephoneNumber: 8475938460
FaxNumber: 2242354652
Practice Location
Address1: 12840 RIVERSIDE DR STE 300
Address2:  
City: VALLEY VILLAGE
State: CA
PostalCode: 916073337
CountryCode: US
TelephoneNumber: 3237981801
FaxNumber: 2242354652
Other Information
ProviderEnumerationDate: 12/20/2005
LastUpdateDate: 11/12/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208G00000XA75852CAY Allopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery) 

No ID Information.


Home