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General NPI Number Information
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NPI Number | 1285630079
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Entity Type | Individual
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Provider Name | RAJENDRA M. CHOKSI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 300 N OTTAWA ST
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City | JOLIET
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State | IL
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Zip | 60432-4009
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Country | US
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Telephone | 815-726-0311
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Fax | 815-726-0520
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Provider Business Mailing Address
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Address Line | 6728 LAKEVIEW CT
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City | WOODRIDGE
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State | IL
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Zip | 60517-1437
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Country | US
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Telephone | 815-726-0311
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Fax | 815-726-0520
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 036052004
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License Number State | IL
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