Provider Demographics
NPI:1134203938
Name:SETTY, LAKSHMAIAH B N (MD SC)
Entity type:Individual
Prefix:DR
First Name:LAKSHMAIAH
Middle Name:B N
Last Name:SETTY
Suffix:
Gender:M
Credentials:MD SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036048413207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036048413Medicaid
IL3631170950001OtherCIGNA
IL216202033OtherBCBS
C42474Medicare UPIN
IL036048413Medicaid