Healthcare Provider Details

I. General information

NPI: 1285968537
Provider Name (Legal Business Name): R. K. TRIVEDI, M.D., S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2009
Last Update Date: 09/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 BARRINGTON RD SUITE 605
HOFFMAN ESTATES IL
60169-1090
US

IV. Provider business mailing address

PO BOX 958024
HOFFMAN ESTATES IL
60195-8024
US

V. Phone/Fax

Practice location:
  • Phone: 847-755-5588
  • Fax: 847-755-1166
Mailing address:
  • Phone: 847-755-5588
  • Fax: 847-755-1166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAVI K TRIVEDI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 847-755-5588