Individual
DR. GURIQBAL SINGH NANDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
645 S CENTRAL AVE, CHICAGO, IL 60644-5059
(773) 626-4300
(773) 626-3732
Mailing address
195 N. HARBOR DR., SUITE #3302, CHICAGO, IL 60601
(312) 540-0130
(312) 540-6733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036-097928
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01638884
BLUE CROSS BLUE SHIELD
IL
05
—
036097928
—
IL
Enumeration date
12/27/2006
Last updated
06/25/2008
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