Provider Demographics
NPI:1083662068
Name:PATARI, SANJAY KIRIT (MD)
Entity Type:Individual
Prefix:
First Name:SANJAY
Middle Name:KIRIT
Last Name:PATARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 N. BARRINGTON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5019
Mailing Address - Country:US
Mailing Address - Phone:847-884-7771
Mailing Address - Fax:847-884-0666
Practice Address - Street 1:1585 N. BARRINGTON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5019
Practice Address - Country:US
Practice Address - Phone:847-884-7771
Practice Address - Fax:847-884-0666
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036105302207XS0106X
IL036-105302207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036105302Medicaid
IL972040 202194Medicare PIN
ILH65037Medicare UPIN