Individual
GAURANG GUJARATHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1710 W COURT ST, KANKAKEE, IL 60901
(815) 936-3200
(815) 936-3203
Mailing address
1000 REMINGTON BLVD STE 100, BOLINGBROOK, IL 60440-4707
(630) 914-2898
(630) 914-2469
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036133707
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036133707
STATE LICENSE
IL
Enumeration date
06/27/2011
Last updated
07/21/2022
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