Provider Demographics
NPI:1467495648
Name:MAJUMDAR, SANJOY (MD)
Entity Type:Individual
Prefix:
First Name:SANJOY
Middle Name:
Last Name:MAJUMDAR
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 1:5958 W LAWRENCE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-3130
Mailing Address - Country:US
Mailing Address - Phone:773-282-4572
Mailing Address - Fax:630-820-6730
Practice Address - Street 1:5958 W LAWRENCE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-3130
Practice Address - Country:US
Practice Address - Phone:773-282-4572
Practice Address - Fax:630-820-6730
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC 44103Medicare UPIN
IL778390/L08689Medicare ID - Type Unspecified
IL576200/L76922Medicare ID - Type Unspecified