Individual
KIRAN R GANDHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2701 W 68TH ST, FLOOR 2, CHICAGO, IL 60629-1813
(773) 884-9000
(708) 423-2991
Mailing address
9532 MINNICK AVE APT 2E, OAK LAWN, IL 60453-9012
(708) 529-3027
(708) 529-3657
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036066641
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036066641
—
IL
01
—
1619540
BCBS PROVIDER ID
IL
01
—
250004156
RAILROAD MEDICARE
IL
01
—
610439700
US DEPT OF LABOR
IL
Enumeration date
01/24/2007
Last updated
01/10/2019
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