Basic Information
| Provider Information | |||||||||
| NPI: | 1750502928 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAKANI | ||||||||
| FirstName: | SIDDHARTHA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 NORTH 95TH PLAZA # 5 | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4026508157 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | CREIGHTON UNIVERSITY MEDICAL CENTER | ||||||||
| Address2: | 601 NORTH 30TH STREET | ||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4022804392 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4971 | NE | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.