Provider Demographics
NPI:1053459412
Name:ERSAHIN, CAGATAY H (MD)
Entity type:Individual
Prefix:
First Name:CAGATAY
Middle Name:H
Last Name:ERSAHIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 S FIRST AVE
Mailing Address - Street 2:EMS BLDG., RM. 2209
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153
Mailing Address - Country:US
Mailing Address - Phone:708-216-3250
Mailing Address - Fax:708-216-2620
Practice Address - Street 1:2160 S FIRST AVE
Practice Address - Street 2:EMS BLDG., RM. 2209
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153
Practice Address - Country:US
Practice Address - Phone:708-216-3250
Practice Address - Fax:708-216-2620
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-112169207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology