Individual
DR. GOPAL MADHAV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 W 95TH ST, STE 6, EVERGREEN PARK, IL 60805-1901
(708) 423-7734
(708) 423-3282
Mailing address
3900 W 95TH ST, STE 6, EVERGREEN PARK, IL 60805-1901
(708) 423-7734
(708) 423-3282
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-058991
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036058991
—
IL
Enumeration date
06/12/2005
Last updated
12/17/2021
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