MEDICARE: GURMUKH SINGH PA-C

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	363AM0700X	Medical Physician Assistant	085-004305	IL

General Provider Information

NPI Number	:	1356616288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GURMUKH SINGH PA-C

Provider Business Mailing Address
First Line	:	1754 W GOLF RD
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4071
Country	:	US
Telephone Number	:	224-265-9010
Fax Number	:

Provider Business Practice Location Address
First Line	:	1754 W GOLF RD
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-4071
Country	:	US
Telephone Number	:	224-265-9010
Fax Number	:

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

Provider Enumeration Date	:	03/10/2012
Last Update Date	:	03/26/2021

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Directions to “ GURMUKH SINGH PA-C” Practice Location

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