Provider Demographics
NPI:1174937106
Name:SIVAGNANAM, MILANI (MD)
Entity type:Individual
Prefix:
First Name:MILANI
Middle Name:
Last Name:SIVAGNANAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W 22ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1563
Mailing Address - Country:US
Mailing Address - Phone:630-573-5000
Mailing Address - Fax:630-451-5472
Practice Address - Street 1:929 RIDGE RD STE 2
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1769
Practice Address - Country:US
Practice Address - Phone:219-836-2740
Practice Address - Fax:219-836-2845
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036148904207RN0300X
IN01087311A207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology