Madhav, Gopal
Madhav, Gopal is an sole proprietor health care provider with primary practice located at 3900 W 95Th St Ste 6, Evergreen Park IL 60805-1901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Madhav, Gopal can be contacted via phone (708) 423-7734.Contact Information
Primary practice address
3900 W 95Th St Ste 6
Evergreen Park IL 60805-1901
Phone: (708) 423-7734
Fax: (708) 423-3282
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-058991 | Illinois |
Profile Details
| NPI number | 1649274119 |
|---|---|
| LBN Legal business name | Madhav, Gopal |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2005 |
| Last updated | Dec 17th, 2021 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649274119 | NPPES |
| Illinois | MEDICAID | 036058991 |
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