Individual
DR. KOMAL PREM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
4803 W PEBBLE BEACH DR, WADSWORTH, IL 60083-9277
(224) 627-6046
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/19/2013
Last updated
03/19/2013
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