Provider Demographics
NPI:1508262205
Name:SANDHU, GURIQBAL S (FNP)
Entity Type:Individual
Prefix:
First Name:GURIQBAL
Middle Name:S
Last Name:SANDHU
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1992 FESCUE DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-4302
Mailing Address - Country:US
Mailing Address - Phone:815-212-9739
Mailing Address - Fax:
Practice Address - Street 1:977 N OAKLAWN AVE
Practice Address - Street 2:SUITE # 104
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-1045
Practice Address - Country:US
Practice Address - Phone:630-832-1775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209011839363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily