Provider Demographics
NPI:1487825824
Name:SAROJ K VERMA MD SC
Entity Type:Organization
Organization Name:SAROJ K VERMA MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAROJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:VERMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD SC
Authorized Official - Phone:773-721-4900
Mailing Address - Street 1:10701 S EWING AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-6606
Mailing Address - Country:US
Mailing Address - Phone:773-721-4900
Mailing Address - Fax:773-721-8963
Practice Address - Street 1:10701 S EWING AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-6606
Practice Address - Country:US
Practice Address - Phone:773-721-4900
Practice Address - Fax:773-721-8963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036048935Medicaid
IL036103707Medicaid
ILL86249Medicare UPIN
ILK20851Medicare UPIN
ILL02956Medicare UPIN
IL036103707Medicaid