Provider Demographics
NPI:1255836888
Name:SANGANI, DEEP BHUPAT (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEP
Middle Name:BHUPAT
Last Name:SANGANI
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 1:1725 W HARRISON ST STE 1159
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3883
Mailing Address - Country:US
Mailing Address - Phone:312-942-5020
Mailing Address - Fax:
Practice Address - Street 1:1725 W HARRISON ST STE 1159
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3883
Practice Address - Country:US
Practice Address - Phone:312-942-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.160363207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease