Provider Demographics
NPI:1467521278
Name:ASHA GANDHI M.D.S.C
Entity Type:Organization
Organization Name:ASHA GANDHI M.D.S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-406-3340
Mailing Address - Street 1:351 GREENLEAF AVE STE F
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60085-5701
Mailing Address - Country:US
Mailing Address - Phone:847-406-3340
Mailing Address - Fax:847-406-3345
Practice Address - Street 1:351 GREENLEAF AVE STE F
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:IL
Practice Address - Zip Code:60085-5701
Practice Address - Country:US
Practice Address - Phone:847-406-3340
Practice Address - Fax:847-406-3345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036051633207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036051633Medicaid
IL036051633Medicaid
IL212108Medicare ID - Type Unspecified