Provider Demographics
NPI:1457460156
Name:HUMAD, SATYENDRA KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SATYENDRA
Middle Name:KUMAR
Last Name:HUMAD
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 1:800 AUSTIN ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3439
Mailing Address - Country:US
Mailing Address - Phone:847-866-8988
Mailing Address - Fax:847-866-8990
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:SUITE 208
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3439
Practice Address - Country:US
Practice Address - Phone:847-866-8988
Practice Address - Fax:847-866-8990
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036064710207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31601940OtherBC/BS
IL036064710Medicaid
ILC41398Medicare UPIN
IL036064710Medicaid