Srinivasan, Gopal
Srinivasan, Gopal is an sole proprietor health care provider with primary practice located at 1501 S California Ave , Chicago IL 60608-1732. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Srinivasan, Gopal can be contacted via phone (773) 257-6476.Contact Information
Primary practice address
1501 S California Ave
Chicago IL 60608-1732
Phone: (773) 257-6476
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 036-049107 | Illinois |
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036-049107 | Illinois |
Profile Details
NPI number | 1417958133 |
---|---|
LBN Legal business name | Srinivasan, Gopal |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 3rd, 2005 |
Last updated | May 23rd, 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1417958133 | NPPES |
Illinois | MEDICAID | 036-049107-1 |
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