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Individual

DR. ANISH PRAVIN PITHADIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3633 W LAKE AVE STE 108, GLENVIEW, IL 60026-5801
(847) 510-2805
(847) 510-2806
Mailing address
3633 W LAKE AVE STE 108, GLENVIEW, IL 60026-5801
(847) 510-2805
(847) 510-2806

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-116564
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1619414
BCBS GRP
IL
05
3633309286030501
IL
Enumeration date
03/23/2007
Last updated
11/14/2022
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