Provider Demographics
NPI:1437101094
Name:GILL, KULJEET (MD)
Entity Type:Individual
Prefix:
First Name:KULJEET
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1295
Mailing Address - Country:US
Mailing Address - Phone:630-690-4553
Mailing Address - Fax:630-690-2293
Practice Address - Street 1:25 N WINFIELD RD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1295
Practice Address - Country:US
Practice Address - Phone:630-690-4553
Practice Address - Fax:630-690-2293
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108659207RS0012X
FLFLME00890312084N0400X
IL036-1086592084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1617373OtherBCBS
IL206147OtherMEDICARE PTAN (GROUP)
ILF400198611OtherMEDICARE PTAN (INDIVIDUAL)
FL273307200Medicaid
IL036108659OtherMEDICAID
IL036108659Medicaid
ILP00454636Medicare PIN
IL036108659OtherMEDICAID
ILK45473Medicare PIN
FL273307200Medicaid
ILK53464Medicare PIN