Provider Demographics
NPI:1700966413
Name:BARNABAS, SATISH T (MD)
Entity Type:Individual
Prefix:
First Name:SATISH
Middle Name:T
Last Name:BARNABAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5015 N PAULINA STREET
Mailing Address - Street 2:SUITE 225
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2756
Mailing Address - Country:US
Mailing Address - Phone:773-561-4440
Mailing Address - Fax:773-561-9211
Practice Address - Street 1:5015 N PAULINAA STREET
Practice Address - Street 2:SUITE 225
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2756
Practice Address - Country:US
Practice Address - Phone:773-561-4440
Practice Address - Fax:773-561-9211
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036061422207R00000X
IN01058678A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036061422Medicaid
0001617954OtherBCBS
IL036061422Medicaid
776460Medicare ID - Type Unspecified