MEDICARE: RAJA SINGH GILL MD

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	2084P0800X	Psychiatry Physician	036120999	IL

General Provider Information

NPI Number	:	1851540165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJA SINGH GILL MD

Provider Business Mailing Address
First Line	:	62 BAYBROOK LN
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1640
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 S CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1729
Country	:	US
Telephone Number	:	773-592-8454
Fax Number	:

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

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	09/10/2008

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