Provider Demographics
NPI:1194847228
Name:SANA, SHERJEEL (MD)
Entity Type:Individual
Prefix:
First Name:SHERJEEL
Middle Name:
Last Name:SANA
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 1:2801 W KINNICKINNIC RIVER PKWY STE 980
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3669
Mailing Address - Country:US
Mailing Address - Phone:414-384-5111
Mailing Address - Fax:414-384-5040
Practice Address - Street 1:2801 W KINNICKINNIC RIVER PKWY STE 980
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215
Practice Address - Country:US
Practice Address - Phone:414-384-5111
Practice Address - Fax:414-384-5040
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036116917207R00000X
UT7309490-1205207R00000X, 208M00000X
IL036-116917207RH0003X
WI69810207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100080635Medicaid
IL036116917Medicaid
ILP00466658OtherRR MEDICARE
I73027Medicare UPIN