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General NPI Number Information
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NPI Number | 1902954381
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Entity Type | Individual
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Provider Name | ANJALI THUKRAL M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 12/31/2020
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Provider Practice Location Address
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Address Line | 17901 GOVERNORS HWY SUITE 103
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City | HOMEWOOD
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State | IL
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Zip | 60430-1144
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Country | US
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Telephone | 708-799-6450
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Fax | 708-799-6560
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Provider Business Mailing Address
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Address Line | PO BOX 2190
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City | ORLAND PARK
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State | IL
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Zip | 60462-1085
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Country | US
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Telephone | 708-799-6450
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Fax | 708-799-6560
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036109201
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License Number State | IL
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