Provider Demographics
NPI:1225341621
Name:THATTE, SUPARNA RAMDAS
Entity Type:Individual
Prefix:
First Name:SUPARNA
Middle Name:RAMDAS
Last Name:THATTE
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 1:1008 MANDALAY CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1980
Mailing Address - Country:US
Mailing Address - Phone:630-961-0797
Mailing Address - Fax:
Practice Address - Street 1:1008 MANDALAY CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1980
Practice Address - Country:US
Practice Address - Phone:630-961-0797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter