Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036-135202 | IL |
N | 111NI0900X | Internist | 036-135202 | IL |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036.135202 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036-135202 | IL |
NPI | 1881983575 |
---|---|
Provider Name | Anjali Anil Joshi |
First Address | Mokena, IL 60448-8399 |
Second Address | Oak Lawn, IL 60453-2600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2011 |
Last Update Date | 17/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036135202 | (05) | IL |