Individual
GAURAV CHATURVEDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1775 BALLARD RD, PARK RIDGE, IL 60068-1005
(847) 318-9340
(847) 318-2966
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036107823
IL
208M00000X
Hospitalist Physician
036107823
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222075
BLUE CROSS GROUP NUMBER
IL
05
—
036107823
—
IL
01
—
363149833
TAX IDENTIFICATION NUMBER
IL
Enumeration date
07/08/2006
Last updated
06/07/2022
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