MEDICARE: KISHAN RAMPERSADSINGH

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	172A00000X	Driver	R51650082046	IL

General Provider Information

NPI Number	:	1962806547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KISHAN RAMPERSADSINGH

Provider Business Mailing Address
First Line	:	415 BELDEN AVE
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-2509
Country	:	US
Telephone Number	:	872-600-8523
Fax Number	:	888-316-0994

Provider Business Practice Location Address
First Line	:	415 BELDEN AVE
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-2509
Country	:	US
Telephone Number	:	872-600-8523
Fax Number	:	888-316-0994

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

Provider Enumeration Date	:	10/10/2014
Last Update Date	:	10/10/2014

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Directions to “ KISHAN RAMPERSADSINGH ” Practice Location

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