Provider Demographics
NPI:1679747521
Name:DR. THAKRAR ASSOCIATES M.D.;S.C.
Entity Type:Organization
Organization Name:DR. THAKRAR ASSOCIATES M.D.;S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:V
Authorized Official - Last Name:THAKRAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-642-6006
Mailing Address - Street 1:161 E CHICAGO AVE APT 52B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-6684
Mailing Address - Country:US
Mailing Address - Phone:312-642-6006
Mailing Address - Fax:773-250-0946
Practice Address - Street 1:161 E CHICAGO AVE APT 52B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-6684
Practice Address - Country:US
Practice Address - Phone:312-642-6006
Practice Address - Fax:773-250-0946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360463682085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036046368Medicaid
IL211074Medicare PIN
IL1750391843Medicare UPIN