Provider Demographics
NPI:1548559321
Name:KANSAL, NEHA (MD)
Entity Type:Individual
Prefix:
First Name:NEHA
Middle Name:
Last Name:KANSAL
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 1:5000 S 5TH AVENUE
Mailing Address - Street 2:EDWARD HINES, JR., VETERANS ADMINISTRATION HOSPITAL
Mailing Address - City:HINES
Mailing Address - State:IL
Mailing Address - Zip Code:60141
Mailing Address - Country:US
Mailing Address - Phone:708-202-2707
Mailing Address - Fax:
Practice Address - Street 1:5000 S 5TH AVENUE
Practice Address - Street 2:EDWARD HINES, JR., VETERANS ADMINISTRATION HOSPITAL
Practice Address - City:HINES
Practice Address - State:IL
Practice Address - Zip Code:60141
Practice Address - Country:US
Practice Address - Phone:708-202-2707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036135444207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine