Individual
DR. KRUTI PRAFUL MANIAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2650 RIDGE AVE., DEPT. OF PATHOLOGY, EVANSTON, IL 60201-1057
(847) 570-2182
(847) 570-1938
Mailing address
2650 RIDGE AVE., DEPT. OF PATHOLOGY, EVANSTON, IL 60201-1057
(847) 570-2182
(847) 570-1938
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
036133123
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
D0071620
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045344700
—
MD
Enumeration date
06/02/2008
Last updated
11/15/2021
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