Provider Demographics
NPI:1497828537
Name:RAM S PANKAJ MD SC
Entity Type:Organization
Organization Name:RAM S PANKAJ MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:PANKAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-725-7700
Mailing Address - Street 1:1240 ESSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435
Mailing Address - Country:US
Mailing Address - Phone:815-725-7700
Mailing Address - Fax:815-744-6257
Practice Address - Street 1:1240 ESSINGTON RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435
Practice Address - Country:US
Practice Address - Phone:815-725-7700
Practice Address - Fax:815-744-6257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
207759Medicare ID - Type Unspecified