Healthcare Provider Details

I. General information

NPI: 1184073801
Provider Name (Legal Business Name): GAURAV SINGH M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2016
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E ILLINOIS ST
CHICAGO IL
60611-5426
US

IV. Provider business mailing address

160 E ILLINOIS ST
CHICAGO IL
60611-5426
US

V. Phone/Fax

Practice location:
  • Phone: 312-728-3698
  • Fax:
Mailing address:
  • Phone: 312-728-3698
  • Fax: 936-213-6342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number036161604
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: