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General NPI Number Information
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NPI Number | 1831505106
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Entity Type | Individual
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Provider Name | INDUPREET NAGRA MD
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Gender | Female
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 10/20/2022
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Provider Practice Location Address
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Address Line | 8311 ROOSEVELT RD
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City | FOREST PARK
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State | IL
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Zip | 60130
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Country | US
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Telephone | 708-209-4180
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Fax | 708-209-2280
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Provider Business Mailing Address
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Address Line | 630 N STATE ST APT 2507
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City | CHICAGO
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State | IL
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Zip | 60654-5581
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 290528
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036.146769
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License Number State | IL
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