Healthcare Provider Details

I. General information

NPI: 1215912126
Provider Name (Legal Business Name): MANDEEP S GILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10370 HALIGUS RD STE 103
HUNTLEY IL
60142-9582
US

IV. Provider business mailing address

120 W 22ND ST
OAK BROOK IL
60523-1557
US

V. Phone/Fax

Practice location:
  • Phone: 847-531-5911
  • Fax:
Mailing address:
  • Phone: 630-573-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036162090
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036162090
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number036.162090
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number36737
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: