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Individual

DR. ROOP REKHA SHIVPURI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.,

Contact information

Practice address
2050 LARKIN AVE, ELGIN, IL 60123-5888
(847) 697-2500
(847) 697-2565
Mailing address
2050 LARKIN AVE, #100, ELGIN, IL 60123-4405
(847) 697-2500
(847) 697-2565

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36059029
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4500577
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/30/2005
Last updated
09/05/2007
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