Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038.013004 | IL |
N | 111NS0005X | Chiropractic Sports Physician | 038.013004 | IL |
NPI | 1104379544 |
---|---|
Provider Name | Darshan Gandhi |
First Address | Carol Stream, IL 60188-1589 |
Second Address | Carol Stream, IL 60188-1589 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2016 |
Last Update Date | 02/08/2016 |