Individual
DHAVAL N THAKKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1850 GATEWAY DR, SYCAMORE, IL 60178-3192
(815) 758-8671
Mailing address
1850 GATEWAY DR, SYCAMORE, IL 60178-3192
(815) 758-8671
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-103399
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103399
—
IL
01
—
062767
HEALTH ALLIANCE
IL
Enumeration date
08/13/2006
Last updated
06/07/2010
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