Basic Information
| Provider Information | |||||||||
| NPI: | 1073003844 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GANDHI MEDICAL CONSULTANTS S C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1051 ESSINGTON RD STE 290 | ||||||||
| Address2: | |||||||||
| City: | JOLIET | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604352842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157737827 | ||||||||
| FaxNumber: | 8152548442 | ||||||||
| Practice Location | |||||||||
| Address1: | 1051 ESSINGTON RD STE 292 | ||||||||
| Address2: | |||||||||
| City: | JOLIET | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604352801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157737827 | ||||||||
| FaxNumber: | 8158382656 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2018 | ||||||||
| LastUpdateDate: | 02/15/2022 | ||||||||
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| AuthorizedOfficialLastName: | GANDHI | ||||||||
| AuthorizedOfficialFirstName: | BHAVESH | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6308460135 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 02/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QG0300X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LG0600X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.