Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 2003021829 | MO |
Y | 207RI0200X | Infectious Disease | IL |
NPI | 1053383125 |
---|---|
Provider Name | Kiran Dhillon |
First Address | Oak Brook, IL 60523-1644 |
Second Address | Palos Heights, IL 60463-1025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 14/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
21622441 | BCBS PROVIDER NO (01) | IL |
I00146 | (02) | IL |
P00273437 | RAILROAD MEDICARE (01) | IL |