Provider Demographics
NPI:1780763516
Name:KADAKIA, SUNIL N (MD)
Entity type:Individual
Prefix:MR
First Name:SUNIL
Middle Name:N
Last Name:KADAKIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:912 W NORTHEAST HWY
Mailing Address - Street 2:#100
Mailing Address - City:FOX RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60021
Mailing Address - Country:US
Mailing Address - Phone:847-516-2424
Mailing Address - Fax:847-750-0390
Practice Address - Street 1:912 W NORTHEAST HWY
Practice Address - Street 2:#100
Practice Address - City:FOX RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60021
Practice Address - Country:US
Practice Address - Phone:847-516-2424
Practice Address - Fax:847-750-0390
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2016-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036074104207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036074107Medicaid
IL05625392OtherBLUE CROSS & BLUE SHIELD
IL060067326OtherRAILROAD MEDICARE
ILK20749Medicare ID - Type Unspecified
ILK20751Medicare ID - Type Unspecified
IL036074107Medicaid
IL05625392OtherBLUE CROSS & BLUE SHIELD