MEDICARE: RANJIT SINGH WAHI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	036-76159	IL

General Provider Information

NPI Number	:	1013012558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANJIT SINGH WAHI M.D.

Provider Business Mailing Address
First Line	:	8 CASCADE CT W
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-0715
Country	:	US
Telephone Number	:	630-887-1483
Fax Number	:	630-887-1483

Provider Business Practice Location Address
First Line	:	3522 E 95TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-5164
Country	:	US
Telephone Number	:	773-933-0791
Fax Number	:	773-933-4903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	07/08/2007

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