Provider Demographics
NPI:1750489019
Name:SAKSENA, COLLECTOR B (MD)
Entity Type:Individual
Prefix:MR
First Name:COLLECTOR
Middle Name:B
Last Name:SAKSENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BRIJNANDANLAL
Other - Middle Name:B
Other - Last Name:SAKSENA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1300 FRANKLIN AVE
Mailing Address - Street 2:SUITE # 280
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-3592
Mailing Address - Country:US
Mailing Address - Phone:309-452-9448
Mailing Address - Fax:309-452-9449
Practice Address - Street 1:1300 FRANKLIN AVE
Practice Address - Street 2:SUITE # 280
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-3592
Practice Address - Country:US
Practice Address - Phone:309-452-9448
Practice Address - Fax:309-452-9449
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AS5263669OtherDEA NUMBER
E23423Medicare UPIN