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General NPI Number Information
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NPI Number | 1578117024
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Entity Type | Individual
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Provider Name | PRAGNA MUKESH DHOLAKIA APRN
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Gender | Female
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Dates
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Enumeration Date | 08/01/2019
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 21481 N RAND RD
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City | KILDEER
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State | IL
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Zip | 60047-3061
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Country | US
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Telephone | 847-618-2500
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Fax | 847-618-2809
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE STE 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone | 847-618-2500
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Fax | 847-618-2809
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11000838
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209030804
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License Number State | IL
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