Provider Demographics
NPI:1710161625
Name:PAWEL SARATA MD SC
Entity Type:Organization
Organization Name:PAWEL SARATA MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAWEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SARATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-593-3474
Mailing Address - Street 1:5122 W IRVING PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2624
Mailing Address - Country:US
Mailing Address - Phone:773-282-7952
Mailing Address - Fax:773-282-6158
Practice Address - Street 1:5122 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2624
Practice Address - Country:US
Practice Address - Phone:773-282-7952
Practice Address - Fax:773-282-6158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36108386207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty