Healthcare Provider Details

I. General information

NPI: 1326600099
Provider Name (Legal Business Name): SUBUHI KAUL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 W POLK ST FL 4
CHICAGO IL
60612-3723
US

IV. Provider business mailing address

1950 W POLK ST FL 4
CHICAGO IL
60612-3723
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-6000
  • Fax:
Mailing address:
  • Phone: 312-864-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number036.157923
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125073916
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: