1104915867 NPI number — CITY OF LITCHFIELD

Table of content: NAVREET KALLAR M.D., M.P.H. (NPI 1295770873)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104915867 NPI number — CITY OF LITCHFIELD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF LITCHFIELD
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:
1104915867
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 523
Provider Second Line Business Mailing Address:
120 NORTH MAIN
Provider Business Mailing Address City Name:
HILLSBORO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
217-532-9562
Provider Business Mailing Address Fax Number:
217-532-9608

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 EAST EDWARDS
Provider Second Line Business Practice Location Address:
LITCHFIELD AVE AMBULANCE SERVICE
Provider Business Practice Location Address City Name:
LITCHFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-324-4042
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ULRICI
Authorized Official First Name:
CATHY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
ADMINISTRATIVE ASSISTANT
Authorized Official Telephone Number:
217-532-9562

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , 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)