Organization
CENTER FOR PEDIATRIC GASTROENTEROLOGY & NUTRITION MDSC
Active
Organization
CENTER FOR PEDIATRIC GASTROENTEROLOGY & NUTRITION MDSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJEEV NAGPAL MD (PRESIDENT)
(708) 684-5650
Entity
Organization
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5650
(708) 684-4446
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01605334
BCBC PROVIDER ID
IL
01
—
23300
ADVOCATE HLTH PARTNERS ID
IL
Enumeration date
11/01/2006
Last updated
04/20/2008
Update your record
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