Basic Information
Provider Information
NPI: 1528107265
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: SIMRATA
MiddleName: G
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 255 W MICHIGAN AVE
Address2:  
City: JACKSON
State: MI
PostalCode: 492012218
CountryCode: US
TelephoneNumber: 5177876440
FaxNumber: 5177874146
Practice Location
Address1: 120 N OAK ST
Address2:  
City: HINSDALE
State: IL
PostalCode: 605213829
CountryCode: US
TelephoneNumber: 6308569000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/06/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X36060096ILY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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