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General NPI Number Information
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NPI Number | 1124917190
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Entity Type | Individual
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Provider Name | KAMAL RAJ THAPA MD
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Gender | Male
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 1500 S FAIRFIELD AVE
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City | CHICAGO
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State | IL
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Zip | 60608-1782
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Country | US
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Telephone | 773-257-5701
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Fax |
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Provider Business Mailing Address
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Address Line | 816 S ADAMS ST APT C506
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City | WESTMONT
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State | IL
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Zip | 60559-3612
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Country | US
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Telephone | 929-719-0161
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.085150
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License Number State | IL
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