# MANDEEP S KOHLI DO SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073530069
- **Authorized official:** MRS. ANITA K KOHLI BACHELORS (OFFICE MANAGER)
- **Authorized official phone:** (630) 893-0347

## Contact information

- **Practice address:** 303 E ARMY TRAIL RD, STE\# 131, BLOOMINGDALE, IL 60108-2169
- **Practice address phone:** (630) 893-0347
- **Practice address fax:** (630) 893-1467
- **Mailing address:** 360 DONNA LN, BLOOMINGDALE, IL 60108-8800
- **Mailing address phone:** (630) 893-0347
- **Mailing address fax:** (630) 893-1467

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | IL | Yes |

## Other

- **Enumeration date:** 07/16/2006
- **Last updated:** 11/06/2007