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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 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 1417958133 NPPES
Illinois MEDICAID 036-049107-1

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