Provider Demographics
NPI:1508907122
Name:BABU, NARAYANAPPA SATHISH (MD, MS, FRCS, MSC)
Entity Type:Individual
Prefix:
First Name:NARAYANAPPA
Middle Name:SATHISH
Last Name:BABU
Suffix:
Gender:M
Credentials:MD, MS, FRCS, MSC
Other - Prefix:DR
Other - First Name:SATHISH
Other - Middle Name:NARAYANAPPA
Other - Last Name:BABU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD,MS,FRCS,MSC
Mailing Address - Street 1:209 LILAC ST
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-2020
Mailing Address - Country:US
Mailing Address - Phone:505-553-9058
Mailing Address - Fax:
Practice Address - Street 1:8348 LEMONT RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-1510
Practice Address - Country:US
Practice Address - Phone:847-354-7565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2013-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.122098207Q00000X, 207QA0401X, 207QA0505X, 207QG0300X, 207R00000X, 207RA0401X, 2083P0901X, 208600000X, 208D00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL60025-30Medicaid
ILIL 2437002OtherINDIVIDUAL PTAN
IL60202-01Medicaid
IL213215007OtherINDIVIDUAL PTAN