Provider Demographics
NPI:1467556837
Name:SIPAHI, MEHMET (MD)
Entity Type:Individual
Prefix:DR
First Name:MEHMET
Middle Name:
Last Name:SIPAHI
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 1:200 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914-4689
Mailing Address - Country:US
Mailing Address - Phone:815-933-9660
Mailing Address - Fax:815-929-0014
Practice Address - Street 1:200 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-4689
Practice Address - Country:US
Practice Address - Phone:815-933-9660
Practice Address - Fax:815-929-0014
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036070341207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036070341Medicaid
IL036070341Medicaid
D16321Medicare UPIN