1497816268 NPI number — DR. AMRIT R SINGH MD

Table of content: DR. AMRIT R SINGH MD (NPI 1497816268)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497816268 NPI number — DR. AMRIT R SINGH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SINGH
Provider First Name:
AMRIT
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1497816268
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12179 REGENCY PKWY
Provider Second Line Business Mailing Address:
VITAS HEALTHCARE AND HOSPICE
Provider Business Mailing Address City Name:
HUNTLEY
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60142-7644
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-754-6928
Provider Business Mailing Address Fax Number:
847-426-6216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12179 REGENCY PKWY
Provider Second Line Business Practice Location Address:
VITAS HEALTHCARE AND HOSPICE
Provider Business Practice Location Address City Name:
HUNTLEY
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60142-7644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-754-6928
Provider Business Practice Location Address Fax Number:
847-426-6216
Provider Enumeration Date:
12/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  000035049 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QG0300X , with the licence number: 036.120343 , 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: 8976530 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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