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Individual

GAURAVA AGARWAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
446 E ONTARIO ST, CHICAGO, IL 60611-4418
(312) 695-1920
Mailing address
446 E ONTARIO ST, CHICAGO, IL 60611-4418

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
125053133
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125053133
LICENSE NUMBER
IL
Enumeration date
08/22/2008
Last updated
08/22/2008
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