Gordhan, Ajeet D

Gordhan, Ajeet D is an sole proprietor health care provider with primary practice located at 2200 Fort Jesse Rd Suite 280, Normal IL 61761-6286. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Neuroradiology is his primary health care specialty. Gordhan, Ajeet D can be contacted via phone (309) 452-1788.

Contact Information

Primary practice address
2200 Fort Jesse Rd Suite 280 Normal IL 61761-6286
Phone: (309) 452-1788
Fax: (309) 862-1302
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuroradiology 2085N0700X 36110222 Illinois
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 36110222 Illinois

Profile Details

NPI number 1306892369
LBN Legal business name Gordhan, Ajeet D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 25th, 2006
Last updated Nov 16th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306892369 NPPES
Illinois MEDICAID 036110222*1

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