1760591903 NPI number — SALIL V DOSHI MD

Table of content: SALIL V DOSHI MD (NPI 1760591903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760591903 NPI number — SALIL V DOSHI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOSHI
Provider First Name:
SALIL
Provider Middle Name:
V
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1760591903
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10001 W INNOVATION DR STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53226-4851
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-938-3838
Provider Business Mailing Address Fax Number:
888-919-1083

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1739 FREEDOM DR STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPERVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60563-3565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-938-3838
Provider Business Practice Location Address Fax Number:
888-919-1083
Provider Enumeration Date:
08/30/2006

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: 207Y00000X , with the licence number:  036093674 , 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: 1000293 . This is a "UNITED HEALTHCARE ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 5816555 . This is a "AETNA PROVIDER ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 788672 . This is a "UNITED HEALTHCARE ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 595493303 . This is a "CIGNA PROVIDER ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 036093674 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4848466001 . This is a "CIGNA PROVIDER ID" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 040017862 . This is a "RAILROAD MEDICARE UPIN" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 040017863 . This is a "RAILROAD MEDICARE UPIN" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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