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General NPI Number Information
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NPI Number | 1003961343
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Entity Type | Organization
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Legal Business Name | SUDHIR M GOKHALE MD SC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 10735 S CICERO AVE STE 100
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City | OAK LAWN
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State | IL
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Zip | 60453-6210
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Country | US
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Telephone | 708-636-2211
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Fax | 708-636-5552
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Provider Business Mailing Address
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Address Line | 10735 S CICERO AVE STE 100
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City | OAK LAWN
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State | IL
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Zip | 60453-6210
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Country | US
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Telephone | 708-636-2211
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Fax | 708-636-5552
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Authorized Official
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Title or Position | MD
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Name | SUDHIR GOKAHLE
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Credential |
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Telephone | 708-636-2211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 036058650
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036058650
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License Number State | IL
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