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General NPI Number Information
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NPI Number | 1578826723
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Entity Type | Individual
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Provider Name | GURBIR JOHAL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2012
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Last Update Date | 06/22/2012
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Provider Practice Location Address
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Address Line | 5840 S. MARYLAND AVE., MC4028, U OF CHICAGO, DEPT OF ANESTHESIA
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City | CHICAGO
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State | IL
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Zip | 60637
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Country | US
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Telephone | 773-702-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 4 HORSESHOE CT
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City | MONROE
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State | NJ
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Zip | 08831-2368
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Country | US
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Telephone | 732-306-2879
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 125-060783
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License Number State | IL
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