Provider Demographics
NPI:1053502005
Name:VAGHANI, SAPNA PATEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SAPNA
Middle Name:PATEL
Last Name:VAGHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAPNA
Other - Middle Name:P
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:801 YORK ST
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9008
Mailing Address - Fax:920-684-1439
Practice Address - Street 1:2051 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-1865
Practice Address - Country:US
Practice Address - Phone:815-741-4343
Practice Address - Fax:815-741-8660
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.118998207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology