Provider Demographics
NPI:1104045160
Name:SUKHANI, RADHA (MD)
Entity Type:Individual
Prefix:DR
First Name:RADHA
Middle Name:
Last Name:SUKHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RADHA
Other - Middle Name:
Other - Last Name:SUKHANI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:225 N COLUMBUS DR
Mailing Address - Street 2:UNIT 6005
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7910
Mailing Address - Country:US
Mailing Address - Phone:630-853-8388
Mailing Address - Fax:
Practice Address - Street 1:1 E ERIE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2740
Practice Address - Country:US
Practice Address - Phone:312-649-3939
Practice Address - Fax:312-649-5747
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036064349207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036064349Medicaid
IL2233361OtherBCBS-GROUP
IL2233361OtherBCBS-GROUP
ILK44314Medicare PIN