Provider Demographics
NPI:1013719616
Name:RANGOONWALA, SAQIB (MD)
Entity type:Individual
Prefix:
First Name:SAQIB
Middle Name:
Last Name:RANGOONWALA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 COYLE AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3402
Mailing Address - Country:US
Mailing Address - Phone:224-800-4126
Mailing Address - Fax:
Practice Address - Street 1:1350 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6608
Practice Address - Country:US
Practice Address - Phone:330-675-5706
Practice Address - Fax:330-675-5720
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty