Provider Demographics
NPI:1114205176
Name:MIDWEST GI AND HEPATOLOGY, LLC
Entity Type:Organization
Organization Name:MIDWEST GI AND HEPATOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONU
Authorized Official - Middle Name:
Authorized Official - Last Name:DHILLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-215-3157
Mailing Address - Street 1:401 E ONTARIO ST
Mailing Address - Street 2:APT 2909
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3051
Mailing Address - Country:US
Mailing Address - Phone:630-215-3157
Mailing Address - Fax:
Practice Address - Street 1:610 S MAPLE AVE
Practice Address - Street 2:SUITE 2600
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1091
Practice Address - Country:US
Practice Address - Phone:708-290-1010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatologyGroup - Single Specialty