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General NPI Number Information
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NPI Number | 1003127895
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Entity Type | Individual
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Provider Name | DR. SUNITA DERVESH KOUL
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Gender | Female
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 1879 BAY SCOTT CIR STE 111
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City | NAPERVILLE
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State | IL
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Zip | 60540-1109
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Country | US
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Telephone | 630-961-1341
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Fax | 630-961-1782
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Provider Business Mailing Address
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Address Line | 3319 DANLAUR CT
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City | NAPERVILLE
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State | IL
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Zip | 60564-4213
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Country | US
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Telephone | 515-991-7370
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036132608
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 36.132608
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License Number State | IL
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