Provider Demographics
NPI:1386820058
Name:BRAR, JASDIP SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:JASDIP
Middle Name:SINGH
Last Name:BRAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:201 ASTORIA CT
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5177
Mailing Address - Country:US
Mailing Address - Phone:630-545-4935
Mailing Address - Fax:630-592-2239
Practice Address - Street 1:701 WINTHROP AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60139-1405
Practice Address - Country:US
Practice Address - Phone:630-545-4935
Practice Address - Fax:630-592-2239
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-12
Last Update Date:2019-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.120864207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036120864Medicaid