Healthcare Provider Details

I. General information

NPI: 1124291935
Provider Name (Legal Business Name): RANJIT K. TEJI MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2008
Last Update Date: 04/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3344 S HALSTED ST
CHICAGO IL
60608-6742
US

IV. Provider business mailing address

332 HAMBLETONIAN DR
OAK BROOK IL
60523-2620
US

V. Phone/Fax

Practice location:
  • Phone: 773-523-9550
  • Fax: 773-523-3245
Mailing address:
  • Phone: 630-850-9343
  • Fax: 630-850-9391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6076-671-1
License Number StateIL

VIII. Authorized Official

Name: DR. JAGJIT S. TEJI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 630-850-9343