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1083639405

NPI Code Detail

MEDICARE: BRINDA KRISHNAN M.D.

MEDICARE: BRINDA KRISHNAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	MD-066453-L	PA
2	207P00000X	Emergency Medicine Physician	D0059058	MD
3	207P00000X	Emergency Medicine Physician	0101232438	VA
4	207P00000X	Emergency Medicine Physician		IL

General Provider Information

NPI Number	:	1083639405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRINDA KRISHNAN M.D.

Provider Business Mailing Address
First Line	:	1677 ESTATE CIR
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60565-6795
Country	:	US
Telephone Number	:	630-579-9771
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-3077
Country	:	US
Telephone Number	:	773-525-6780
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	04/18/2008

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Directions to “ BRINDA KRISHNAN M.D.” Practice Location

Language	Start Address	Practice Location

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