Provider Demographics
NPI:1073501615
Name:SAWLANI, AMISHI P
Entity Type:Individual
Prefix:DR
First Name:AMISHI
Middle Name:P
Last Name:SAWLANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 W TALCOTT AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-631-0869
Mailing Address - Fax:773-631-1995
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-631-0869
Practice Address - Fax:773-631-1995
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036076490207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036076490Medicaid
IL915890Medicare PIN
ILE18595Medicare UPIN