Provider Demographics
NPI:1578787867
Name:DR SASIK LTD
Entity Type:Organization
Organization Name:DR SASIK LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SASIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-616-9461
Mailing Address - Street 1:400 E IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191-1668
Mailing Address - Country:US
Mailing Address - Phone:630-616-9461
Mailing Address - Fax:630-616-9467
Practice Address - Street 1:400 E IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:WOOD DALE
Practice Address - State:IL
Practice Address - Zip Code:60191-1668
Practice Address - Country:US
Practice Address - Phone:630-616-9461
Practice Address - Fax:630-616-9467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036085700174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036085700Medicaid
ILF73186Medicare UPIN
IL339750Medicare ID - Type Unspecified