Provider Demographics
NPI:1477627396
Name:PANDYA, DHRUVIL J (MD)
Entity Type:Individual
Prefix:DR
First Name:DHRUVIL
Middle Name:J
Last Name:PANDYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25 N WINFIELD RD FL 3
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1222
Mailing Address - Country:US
Mailing Address - Phone:630-933-2113
Mailing Address - Fax:630-933-4520
Practice Address - Street 1:25 N WINFIELD RD FL 3
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1222
Practice Address - Country:US
Practice Address - Phone:630-933-2113
Practice Address - Fax:630-933-4520
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361329122084A2900X, 2085R0204X, 2084N0400X
IN01088012A2084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology