Healthcare Provider Details

I. General information

NPI: 1720048580
Provider Name (Legal Business Name): PREETI MIRCHANDANI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W HIGGINS RD SUITE 670
HOFFMAN ESTATES IL
60195-5220
US

IV. Provider business mailing address

1001 OAKLAND DR
BARRINGTON IL
60010-6308
US

V. Phone/Fax

Practice location:
  • Phone: 847-884-7710
  • Fax: 847-884-8094
Mailing address:
  • Phone: 847-445-6152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: