Organization
KISHOR AJMERE MD LTD
Active
Organization
KISHOR AJMERE MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KISHOR G AJMERE MD (PHYSICIAN)
(815) 744-6023
Entity
Organization
Contact information
Practice address
2435 GLENWOOD AVE, STE 110, JOLIET, IL 60435-5461
(815) 744-6005
(815) 744-6023
Mailing address
2435 GLENWOOD AVE, STE 110, JOLIET, IL 60435-5461
(815) 744-6005
(815) 744-6023
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9900432
BC/BS OF ILLINOIS
IL
Enumeration date
08/05/2006
Last updated
08/22/2020
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