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General NPI Number Information
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NPI Number | 1679629331
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Entity Type | Organization
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Legal Business Name | ROHANISH ENTERPRISES INC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 290 SPRINGFIELD DRIVE SUITE 140
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City | BLOOMINGDALE
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State | IL
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Zip | 60108
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Country | US
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Telephone | 630-582-3120
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Fax | 630-582-3137
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Provider Business Mailing Address
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Address Line | 290 SPRINGFIELD DRIVE SUITE 140
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City | BLOOMINGDALE
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State | IL
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Zip | 60108
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Country | US
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Telephone | 630-582-3120
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Fax | 630-582-3137
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Authorized Official
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Title or Position | OWNER
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Name | JUZER CHINWALLA
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Credential | DDS
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Telephone | 630-582-3120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 019023850
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License Number State | IL
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