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Individual

JANKI J GANDHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
25 N WINFIELD RD STE 500, WINFIELD, IL 60190-1379
(630) 232-0280
(630) 933-3626
Mailing address
25 N WINFIELD RD STE 500, WINFIELD, IL 60190-1379
(630) 232-0280
(630) 933-3626

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-00568
NC
363A00000X
Physician Assistant
Primary
085003460
IL
363AS0400X
Surgical Physician Assistant
085003460
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206147
MEDICARE PTAN (GROUP)
IL
01
206147234
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
01/23/2007
Last updated
10/02/2024
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