Basic Information
| Provider Information | |||||||||
| NPI: | 1255565990 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAMBHIR | ||||||||
| FirstName: | PRIYA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 680 N LAKE SHORE DR STE 1000 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606118709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126959797 | ||||||||
| FaxNumber: | 8475358210 | ||||||||
| Practice Location | |||||||||
| Address1: | 870 N MILWAUKEE AVE | ||||||||
| Address2: | SECOND FLOOR | ||||||||
| City: | VERNON HILLS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600611521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479260106 | ||||||||
| FaxNumber: | 8475358210 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2009 | ||||||||
| LastUpdateDate: | 12/05/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036121954 | IL | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 54207-020 | WI | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A114049 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 25MA09568100 | NJ | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.