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Contact Information

SANJIV S MODI, MD
8955 W 400 N
MICHIGAN CITY, IN46360-9330
 Phone: 219-861-5800
 Fax: 219-861-5543
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for SANJIV S MODI · (Male)

NPI Number 1396730909
Status Active
Credentials MD
Entity Individual
Enumeration date 09/20/2005
Last updated 10/06/2025 - About 8 months ago
Sole proprietor 1 No
Identifiers
  • AZ License # 78356
  • IL License # 036093810
  • IN License # 01093925A
  • IL Medicaid 036093810
  • IL Other L98056 MEDICARE INDIV ID# FOR GROUP 205474
  • IL Other L77781 MEDICARE INDIV ID# FOR GROUP 336140
  • IL Other 830007251 MEDICARE RR
Hospital affiliation(s)
  • MORRIS HOSPITAL & HEALTHCARE CENTERS - (Acute Care)
    150 W HIGH ST
    MORRIS, IL 60450
  • OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER - (Acute Care)
    1100 EAST NORRIS DRIVE
    OTTAWA, IL 61350
  • PROVENA ST JOSEPH MEDICAL CENTER - (Acute Care)
    333 N MADISON
    JOLIET, IL 60435
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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