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Individual

DR. BROJENDRA AGARWALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5841 S MARYLAND AVE, MC 4051, CHICAGO, IL 60637-1447
(773) 795-4475
(773) 702-2319
Mailing address
5841 S MARYLAND AVE, MC 4051, CHICAGO, IL 60637-1447
(773) 795-4475
(773) 702-2319

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
036046668
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01621679
BCBS OF IL
IL
05
036046668
IL
Enumeration date
11/30/2005
Last updated
03/14/2013
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