Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125053946 | IL |
N | 111NI0900X | Internist | 125053946 | IL |
Y | 207RN0300X | Nephrologist | 01076404A | IN |
NPI | 1033432109 |
---|---|
Provider Name | Gaurav Agarwal |
First Address | Oak Brook, IL 60523-1563 |
Second Address | Merrillville, IN 46410-2619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/03/2010 |
Last Update Date | 02/10/2020 |