Provider Demographics
NPI:1134136369
Name:GARG, NARENDRA K (MD)
Entity Type:Individual
Prefix:
First Name:NARENDRA
Middle Name:K
Last Name:GARG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 PALMER CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-9316
Mailing Address - Country:US
Mailing Address - Phone:630-369-6644
Mailing Address - Fax:630-369-3428
Practice Address - Street 1:1879 BAY SCOTT CIR STE 112
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1109
Practice Address - Country:US
Practice Address - Phone:630-369-6644
Practice Address - Fax:630-369-3428
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036069044207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL03606944Medicaid
IL03606944Medicaid
ILD16093Medicare UPIN