Provider Demographics
NPI:1548341290
Name:SAPORTA, ALBERT J (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:J
Last Name:SAPORTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5979
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-5979
Mailing Address - Country:US
Mailing Address - Phone:847-897-5995
Mailing Address - Fax:847-897-5990
Practice Address - Street 1:5140 N CALIFORNIA AVE
Practice Address - Street 2:SUITE 525
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3645
Practice Address - Country:US
Practice Address - Phone:773-769-1400
Practice Address - Fax:773-334-3091
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2014-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036055154207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214529Medicare PIN
C45003Medicare UPIN