Provider Demographics
NPI:1073560512
Name:SALDANHA, RITA PAMELA (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:PAMELA
Last Name:SALDANHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9680 GOLF RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1522
Mailing Address - Country:US
Mailing Address - Phone:847-699-0800
Mailing Address - Fax:847-296-5686
Practice Address - Street 1:17680 KEDZIE AVE STE 201
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2088
Practice Address - Country:US
Practice Address - Phone:708-799-9500
Practice Address - Fax:708-799-9555
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036095144207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D1011370OtherCLIA
IL036095144Medicaid
IL1625963OtherBC/BS
ILL89737Medicare ID - Type Unspecified
IL036095144Medicaid