Provider Demographics
NPI:1396727608
Name:THAKRAR, ANUPAMA (MD)
Entity type:Individual
Prefix:
First Name:ANUPAMA
Middle Name:
Last Name:THAKRAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 E. CHICAGO AVE.
Mailing Address - Street 2:UNIT 52B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:312-864-3838
Mailing Address - Fax:312-864-9295
Practice Address - Street 1:1901 W. HARRISON
Practice Address - Street 2:SUITE LL-500
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-864-3838
Practice Address - Fax:312-864-9295
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058915A2085R0001X
IL036.1162442085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL218860OtherMEDICARE GROUP
IL1616101OtherBCBS
IL218890OtherMEDICARE GROUP
IL036116244Medicaid
IN200288710Medicaid
IL218890OtherMEDICARE GROUP
I10208Medicare UPIN
I10128Medicare UPIN
IL036116244Medicaid
ILP00629316Medicare PIN
ILR03585Medicare PIN