Basic Information
| Provider Information | |||||||||
| NPI: | 1255597985 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINGH | ||||||||
| FirstName: | KAVITA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5140 N. CALIFORNIA AVE. | ||||||||
| Address2: | SUITE 545-GMP | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60625 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7739073038 | ||||||||
| FaxNumber: | 7739893815 | ||||||||
| Practice Location | |||||||||
| Address1: | 1725 W HARRISON ST | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606123841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3125634479 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2008 | ||||||||
| LastUpdateDate: | 04/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036117510 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | 036117510 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.