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NPI Code Detail

MEDICARE: PRITHUL KOIRALA MD

MEDICARE: PRITHUL KOIRALA MD
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
1207R00000XInternal Medicine Physician125.079994IL

General Provider Information

NPI Number : 1396463212
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRITHUL KOIRALA MD
Provider Business Mailing Address
First Line : 824 MULFORD ST APT UNIT2E
Second Line :
City : EVANSTON
State : IL
Zip : 60202-3369
Country : US
Telephone Number : 872-806-7413
Fax Number :
Provider Business Practice Location Address
First Line : 355 RIDGE AVE
Second Line :
City : EVANSTON
State : IL
Zip : 60202-3399
Country : US
Telephone Number : 872-806-7413
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2022
Last Update Date : 08/16/2022

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Directions to “ PRITHUL KOIRALA MD” Practice Location

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