Healthcare Provider Details

I. General information

NPI: 1902817604
Provider Name (Legal Business Name): KAMAYANI NARANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4318 WEST CRYSTAL LAKE RD STE J DRS NARANG & ASSOCIATES LTD
MC HENRY IL
60050-4250
US

IV. Provider business mailing address

4318 WEST CRYSTAL LAKE RD STE J DRS NARANG & ASSOCIATES LTD
MC HENRY IL
60050-4250
US

V. Phone/Fax

Practice location:
  • Phone: 815-344-1500
  • Fax: 815-344-3685
Mailing address:
  • Phone: 815-344-1500
  • Fax: 815-344-3685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number36056970
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier36056970
Identifier TypeMEDICAID
Identifier StateIL
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: