Basic Information
Provider Information
NPI: 1043553571
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MUGVE
FirstName: NEAL
MiddleName: RANJIT
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2160 S 1ST AVE
Address2: LOYOLA DEPARTMENT OF ANESTHESIA
City: MAYWOOD
State: IL
PostalCode: 601533328
CountryCode: US
TelephoneNumber: 7082169169
FaxNumber: 7082161249
Practice Location
Address1: 2160 S 1ST AVE
Address2: LOYOLA DEPARTMENT OF ANESTHESIA
City: MAYWOOD
State: IL
PostalCode: 601533328
CountryCode: US
TelephoneNumber: 7082169169
FaxNumber: 7082161249
Other Information
ProviderEnumerationDate: 04/03/2013
LastUpdateDate: 04/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X125.062877ILN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000X036139155ILY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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