Provider Demographics
NPI:1538260609
Name:SINHA, SUSHANT K (DO)
Entity type:Individual
Prefix:DR
First Name:SUSHANT
Middle Name:K
Last Name:SINHA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 W PERSHING RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-1633
Mailing Address - Country:US
Mailing Address - Phone:217-875-0300
Mailing Address - Fax:217-875-9525
Practice Address - Street 1:646 W PERSHING RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-1633
Practice Address - Country:US
Practice Address - Phone:217-875-0300
Practice Address - Fax:217-875-9525
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
285668OtherHEALTHLINK
371353894 0011OtherCIGNA
IL0005815226OtherBCBS
034290OtherHEALTH ALLIANCE
371353894 62526 A001OtherTRICARE
371353894 62526 A001OtherTRICARE
ILL52097Medicare PIN
ILE64563Medicare UPIN