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General NPI Number Information
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NPI Number | 1104379544
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Entity Type | Individual
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Provider Name | DARSHAN GANDHI
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Gender | Male
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Dates
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Enumeration Date | 08/02/2016
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 535 CHIPPEWA TRL
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City | CAROL STREAM
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State | IL
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Zip | 60188-1589
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Country | US
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Telephone | 630-589-7633
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Fax |
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Provider Business Mailing Address
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Address Line | 535 CHIPPEWA TRL
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City | CAROL STREAM
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State | IL
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Zip | 60188-1589
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Country | US
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Telephone | 630-589-7633
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.013004
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 038.013004
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License Number State | IL
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