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General NPI Number Information
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NPI Number | 1265407829
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Entity Type | Individual
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Provider Name | SUREKHA P JANI MD
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Gender | Female
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1455 GOLF RD SUITE 212
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City | DES PLAINES
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State | IL
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Zip | 60016
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Country | US
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Telephone | 847-297-1800
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Fax | 847-297-2757
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Provider Business Mailing Address
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Address Line | 6910 S MADISON ST
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City | WILLIOWBROOK
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State | IL
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Zip | 60527
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Country | US
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Telephone | 630-321-2788
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Fax | 630-323-1699
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | IL
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