Individual
DR. MANPREET KAUR SAMRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10026405
TX
207RN0300X
Nephrology Physician
Primary
036140513
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3864809602
MYUTMB 3864809602
—
Enumeration date
08/05/2007
Last updated
04/29/2021
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