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General NPI Number Information
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NPI Number | 1598758047
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Entity Type | Individual
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Provider Name | ROOP REKHA SHIVPURI M.D.,
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Gender | Female
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Dates
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Enumeration Date | 08/30/2005
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Last Update Date | 09/05/2007
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Provider Practice Location Address
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Address Line | 2050 LARKIN AVE
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City | ELGIN
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State | IL
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Zip | 60123-5888
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Country | US
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Telephone | 847-697-2500
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Fax | 847-697-2565
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Provider Business Mailing Address
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Address Line | 2050 LARKIN AVE #100
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City | ELGIN
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State | IL
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Zip | 60123-4405
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Country | US
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Telephone | 847-697-2500
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Fax | 847-697-2565
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 36059029
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License Number State | IL
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