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General NPI Number Information
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NPI Number | 1205000924
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Entity Type | Individual
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Provider Name | MANALI DOSHI KALRA MD
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Gender | Female
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Dates
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Enumeration Date | 04/14/2008
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 3001 GREEN BAY RD
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City | NORTH CHICAGO
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State | IL
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Zip | 60064-3048
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Country | US
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Telephone | 224-610-7151
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Fax |
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Provider Business Mailing Address
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Address Line | 1123 W GRACE ST #3E
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City | CHICAGO
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State | IL
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Zip | 60613-3250
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Country | US
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Telephone |
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036.123163
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License Number State | IL
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