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General NPI Number Information
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NPI Number | 1649945346
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Entity Type | Individual
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Provider Name | MS. DIKSHA KAUL
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Gender | Female
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 11600 S KEDZIE AVE STE D
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City | MERRIONETTE PARK
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State | IL
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Zip | 60803-6307
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Country | US
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Telephone | 708-684-6867
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Fax | 708-684-6869
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Provider Business Mailing Address
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Address Line | APT 524, THE POINT AT 180 180 EASTERN AVENUE
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City | MALDEN
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State | MA
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Zip | 02148
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 036.170390
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License Number State | IL
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