Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 036-079542 | IL |
NPI | 1003899428 |
---|---|
Provider Name | Dr. Anil K Gulati |
First Address | Chicago, IL 60616-2955 |
Second Address | Chicago, IL 60616-2955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 11/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03607952 | (05) | IL |
1606264 | BC BS OF IL (01) | |
354830 | (02) | IL |
E43645 | (02) | |
P00180938 | RR MEDICARE (01) |