Provider Demographics
NPI:1124380712
Name:ZAVERI, GAGANDEEP (PA -C)
Entity Type:Individual
Prefix:MS
First Name:GAGANDEEP
Middle Name:
Last Name:ZAVERI
Suffix:
Gender:F
Credentials:PA -C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 W CENTRAL RD
Mailing Address - Street 2:#3600
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2355
Mailing Address - Country:US
Mailing Address - Phone:847-255-0900
Mailing Address - Fax:847-255-4344
Practice Address - Street 1:880 W CENTRAL RD
Practice Address - Street 2:#3600
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2355
Practice Address - Country:US
Practice Address - Phone:847-255-0900
Practice Address - Fax:847-255-4344
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085004310363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical