Healthcare Provider Details

I. General information

NPI: 1164751913
Provider Name (Legal Business Name): GPR SOLUTIONS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 12/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

554 BOVIDAE CIR
NAPERVILLE IL
60565-6184
US

IV. Provider business mailing address

554 BOVIDAE CIR
NAPERVILLE IL
60565-6184
US

V. Phone/Fax

Practice location:
  • Phone: 630-995-9142
  • Fax:
Mailing address:
  • Phone: 630-995-9142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number036-106311
License Number StateIL

VIII. Authorized Official

Name: DR. GAUTAM SHARMA
Title or Position: PSYCHIATRIST
Credential: M.D.
Phone: 630-995-9142