Individual
INDERJIT K HANSRA-GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.S.
Contact information
Practice address
700 E OGDEN AVE, SUITE 202, WESTMONT, IL 60559-5569
(630) 789-9785
(630) 789-9798
Mailing address
700 E OGDEN AVE, SUITE 202, WESTMONT, IL 60559-5569
(630) 789-9785
(630) 789-9798
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036109458
IL
207RP1001X
Pulmonary Disease Physician
Primary
036109458
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036109458
—
IL
01
—
P00926067
RAILROAD MEDICARE
IL
Enumeration date
08/12/2006
Last updated
01/07/2015
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