Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036-135709 | IL |
N | 111NI0900X | Internist | 036-135709 | IL |
Y | 207RC0000X | Internist - Cardiovascular Disease | 036-135709 | IL |
NPI | 1023285145 |
---|---|
Provider Name | Anshul Aggarwal |
First Address | Woodridge, IL 60517-4903 |
Second Address | Elk Grove Village, IL 60007-3361 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 27/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1720371669 | GROUP PRACTICE NPI (01) | IL |
DS2377 | RRMC GROUP PTAN (01) | IL |
F400165614 | MEDICARE PTAN LOC 16 (01) | IL |
F400165618 | MEDICARE PTAN LOC 15 (01) | IL |
P01402657 | RRMC PTAN (01) | IL |