Individual
KUNJAL KADIWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
660 N WESTMORELAND RD, LAKE FOREST, IL 60045-1659
(847) 535-6911
(847) 535-7203
Mailing address
660 N WESTMORELAND RD, SUITE 100, LAKE FOREST, IL 60045-1659
(847) 582-2134
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085-004822
IL
Other
Enumeration date
11/04/2013
Last updated
07/08/2016
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