Organization
DHANALAKSHMI P. GANESAN MD SC
Active
Organization
DHANALAKSHMI P. GANESAN MD SC
Active
Parent organization
DHANALAKSHMI P GANESAN MD SC
Other names
GRAND-DUPAGE CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DHANALAKSHMI P GANESAN MD SC
Authorized official
DR. DHANA L GANESAN M.D. (OWNER)
(708) 405-6200
Entity
Organization
Contact information
Practice address
7357 NORTH AVE, RIVER FOREST, IL 60305-1230
(708) 405-6200
(708) 405-6223
Mailing address
1200 S YORK RD STE 4150, ELMHURST, IL 60126-5630
(630) 607-6206
(708) 405-6223
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
036094637
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094637
—
IL
Enumeration date
06/03/2010
Last updated
11/14/2011
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