Individual
DR. GHANSHYAM AGARWAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 JORIE BLVD, SUITE 186, OAK BROOK, IL 60523-2213
(630) 954-6700
(630) 954-1555
Mailing address
900 JORIE BLVD, SUITE 186, OAK BROOK, IL 60523-2213
(630) 954-6700
(630) 954-1555
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036100144
IL
2080A0000X
Pediatric Adolescent Medicine Physician
036100144
IL
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
036100144
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100144
—
IL
Enumeration date
06/12/2006
Last updated
04/21/2021
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