Basic Information
| Provider Information | |||||||||
| NPI: | 1437343258 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAROJ GULANI LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2015 N KOLMAR AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8479126474 | ||||||||
| FaxNumber: | 7737721401 | ||||||||
| Practice Location | |||||||||
| Address1: | 1300 10TH ST | ||||||||
| Address2: | |||||||||
| City: | WAUKEGAN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600857604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732611200 | ||||||||
| FaxNumber: | 7732611212 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2007 | ||||||||
| LastUpdateDate: | 09/05/2007 | ||||||||
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| AuthorizedOfficialLastName: | GULANI | ||||||||
| AuthorizedOfficialFirstName: | SAROJ | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6307060260 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | IL | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.