Doctor Name: | INDUPREET NAGRA |
NPI Number: | 1831505106 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 125.066033 |
Business Practice Address: | 3333 Green Bay Rd North Chicago, IL - 600643037 |
Business Phone Number: | 8475788711 |
Business Fax Number: | |
Mailing Address: | 6157 N Sheridan Rd, Apt 24d CHICAGO |
State: | IL |
Postal Code: | 606603089 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/08/2014 |
NPI Last Update Date: | 07/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 125.066033 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |