Individual
JADAV M MORADIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 DEMPSTER ST, SUITE 207, PARK RIDGE, IL 60068-1109
(847) 803-9393
(847) 803-1358
Mailing address
1600 DEMPSTER ST, SUITE 207, PARK RIDGE, IL 60068-1109
(847) 803-9393
(847) 803-1358
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036048772
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01627439
B.C.,B.S.
IL
05
—
036048772
—
IL
01
—
364423658
COMMERCIAL
IL
Enumeration date
09/04/2007
Last updated
03/10/2010
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