1043403884 NPI number — ASHWANI K. GARG, MD

Table of content: (NPI 1043403884)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043403884 NPI number — ASHWANI K. GARG, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASHWANI K. GARG, MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043403884
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2200 W HIGGINS RD
Provider Second Line Business Mailing Address:
SUITE 225
Provider Business Mailing Address City Name:
HOFFMAN ESTATES
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60169-2426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-994-5001
Provider Business Mailing Address Fax Number:
847-882-1905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2200 W HIGGINS RD
Provider Second Line Business Practice Location Address:
SUITE 225
Provider Business Practice Location Address City Name:
HOFFMAN ESTATES
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60169-2426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-994-5001
Provider Business Practice Location Address Fax Number:
847-882-1905
Provider Enumeration Date:
08/24/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GARG
Authorized Official First Name:
ASHWANI
Authorized Official Middle Name:
KUMAR
Authorized Official Title or Position:
FAMILY PHYSICIAN
Authorized Official Telephone Number:
847-994-5001

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  036108096 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2213529 . This is a "FIRST HEALTH" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 7550278 . This is a "CIGNA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 1633858 . This is a "BCBSIL" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 21244725985 . This is a "BEECH STREET" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 7090488 . This is a "AETNA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 5483195 . This is a "CCN" identifier . This identifiers is of the category "OTHER".




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