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Individual

KUNAL BAKSHI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4025 N SHERIDAN RD, CHICAGO, IL 60613-2010
(773) 388-1800
Mailing address
1318 GRANROCK CRES, MISSISSAUGA, ONTARIO L5V 0-E1
(647) 701-0473

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.157847
IL
207Q00000X
Family Medicine Physician
4301107721
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036.157847
IL
Enumeration date
06/25/2015
Last updated
10/21/2021
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