Healthcare Provider Details

I. General information

NPI: 1588039770
Provider Name (Legal Business Name): JIGNA D GANDHI MSN, NP -C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JIGNA D PATEL MSN, NP-C

II. Dates (important events)

Enumeration Date: 12/14/2015
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 E WOODFIELD RD SUITE 300
SCHAUMBURG IL
60173-4776
US

IV. Provider business mailing address

808 E WOODFIELD RD SUITE 100
SCHAUMBURG IL
60173-4816
US

V. Phone/Fax

Practice location:
  • Phone: 847-605-9500
  • Fax: 847-605-8700
Mailing address:
  • Phone: 847-605-0030
  • Fax: 847-637-0737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209013652
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: