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General NPI Number Information
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NPI Number | 1740453166
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Entity Type | Organization
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Legal Business Name | G S THAKKAR MDSC
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 2740 W FOSTER AVE STE 203
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City | CHICAGO
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State | IL
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Zip | 60625-3525
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Country | US
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Telephone | 773-989-3950
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Fax | 773-506-3884
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Provider Business Mailing Address
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Address Line | 2740 W FOSTER AVE STE 203
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City | CHICAGO
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State | IL
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Zip | 60625-3525
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Country | US
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Telephone | 773-989-3950
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Fax | 773-506-3884
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. GITA G THAKKAR
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Credential |
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Telephone | 773-989-3950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036-071876
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License Number State | IL
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