Provider Demographics
NPI:1710217575
Name:DIVEKAR, SATISH
Entity Type:Individual
Prefix:
First Name:SATISH
Middle Name:
Last Name:DIVEKAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1809 BELOIT CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-6740
Mailing Address - Country:US
Mailing Address - Phone:630-428-2644
Mailing Address - Fax:630-428-2644
Practice Address - Street 1:1809 BELOIT CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-6740
Practice Address - Country:US
Practice Address - Phone:630-428-2644
Practice Address - Fax:630-428-2644
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter