Gorla, Kiranmai

Gorla, Kiranmai is an individual health care provider with primary practice located at 1675 Dempster St , Park Ridge IL 60068-1110. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as her primary health care specialty. Gorla, Kiranmai can be contacted via phone (847) 723-7700.

Contact Information

Primary practice address
1675 Dempster St Park Ridge IL 60068-1110
Phone: (847) 723-7700
Fax: (847) 723-9418
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 036126977 Illinois

Profile Details

NPI number 1760686885
LBN Legal business name Gorla, Kiranmai
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2007
Last updated Sep 19th, 2022 - about 3 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 1760686885 NPPES
Illinois MEDICAID 036126977

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