Provider Demographics
NPI:1902183593
Name:B N L SETTY MD SC
Entity Type:Organization
Organization Name:B N L SETTY MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:L SETTY
Authorized Official - Middle Name:N
Authorized Official - Last Name:B
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-725-5044
Mailing Address - Street 1:4955 N MILWAUKEE AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2286
Mailing Address - Country:US
Mailing Address - Phone:773-725-5044
Mailing Address - Fax:773-725-4881
Practice Address - Street 1:4955 N MILWAUKEE AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2286
Practice Address - Country:US
Practice Address - Phone:773-725-5044
Practice Address - Fax:773-725-4881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-048413174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036048413Medicaid
IL036048413Medicaid
IL496400Medicare PIN