MEDICARE: MUKESH M. DOSHI, M.D., S.C.

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	2080P0202X	Pediatric Cardiology Physician		IL

General Provider Information

NPI Number	:	1104012053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MUKESH M. DOSHI, M.D., S.C.

Provider Business Mailing Address
First Line	:	1768 MOON LAKE BLVD
Second Line	:	SUITE 206
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169
Country	:	US
Telephone Number	:	847-882-4300
Fax Number	:	847-882-7269

Provider Business Practice Location Address
First Line	:	1768 MOON LAKE BLVD
Second Line	:	SUITE 206
City	:	HOFFMAN ESTATES
State	:	IL
Zip	:	60169
Country	:	US
Telephone Number	:	847-882-4300
Fax Number	:	847-882-7269

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MUKESH M DOSHI
Credential	:	M.D.
Telephone Number	:	847-882-4300

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	09/24/2007

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