Organization
HINSDALE HEALTH AND NUTRITION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EHTESHAM J GHANI M.D (CLINICAL DIRECTOR)
(630) 325-5185
Entity
Organization
Contact information
Practice address
120 E OGDEN AVE STE 120, HINSDALE, IL 60521-3545
(630) 325-5185
(630) 325-5184
Mailing address
120 E OGDEN AVE STE 120, HINSDALE, IL 60521-3545
(630) 325-5185
(630) 325-5184
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
036092503
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232961
BCBS IL
IL
Enumeration date
05/25/2007
Last updated
09/11/2008
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