Dr Pratip Kumar Nag, MD PHD | |
144 North Ct, Dixon, IL 61021-1224 | |
(815) 285-5437 | |
(815) 285-8928 |
Full Name | Dr Pratip Kumar Nag |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 144 North Ct, Dixon, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437261963 | NPI | - | NPPES |
036133213 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 036-133213 (Illinois) | Primary |
208000000X | Pediatrics | M4388 (Texas) | Secondary |
208000000X | Pediatrics | 96532 (Georgia) | Secondary |
Entity Name | The Board Of Trustees Of The University Of Illinois |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386863819 PECOS PAC ID: 3072422716 Enrollment ID: O20031112000158 |
Entity Name | Ksb Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1073592119 PECOS PAC ID: 7911890009 Enrollment ID: O20040203000860 |
Mailing Address | Practice Location Address |
---|---|
Dr Pratip Kumar Nag, MD PHD 734 Waterside Dr, South Elgin, IL 60177-3715 Ph: (815) 994-8916 | Dr Pratip Kumar Nag, MD PHD 144 North Ct, Dixon, IL 61021-1224 Ph: (815) 285-5437 |
Dr. Maria P Rivera, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 144 North Ct, Dixon, IL 61021 Phone: 815-285-5437 Fax: 815-285-8928 | |
Dr. Natasha Denise Noel, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 144 North Ct, Dixon, IL 61021 Phone: 815-285-5437 | |
Dr. Vijaya A Sayana, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 102 S Hennepin Ave, Dixon, IL 61021 Phone: 815-288-7711 Fax: 815-285-8902 |