Provider Demographics
NPI:1386690139
Name:SINGH, INDER P (MD)
Entity Type:Individual
Prefix:
First Name:INDER
Middle Name:P
Last Name:SINGH
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 1:2150 GREENVIEW RD
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-6629
Mailing Address - Country:US
Mailing Address - Phone:847-498-6279
Mailing Address - Fax:847-498-0784
Practice Address - Street 1:1455 E GOLF ROAD SUITE #116
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1253
Practice Address - Country:US
Practice Address - Phone:847-390-6056
Practice Address - Fax:847-390-6447
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-069808207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036069808Medicaid
IL0031601929OtherPIN BL.CR.BL.SH OF IL
IL0031601929OtherPIN BL.CR.BL.SH OF IL