Provider Demographics
NPI:1619163565
Name:GILL, SUKHJIT S (MD)
Entity Type:Individual
Prefix:
First Name:SUKHJIT
Middle Name:S
Last Name:GILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2266 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-7600
Mailing Address - Country:US
Mailing Address - Phone:773-327-8008
Mailing Address - Fax:773-423-0289
Practice Address - Street 1:2266 N LINCOLN AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-3718
Practice Address - Country:US
Practice Address - Phone:773-327-8008
Practice Address - Fax:773-423-0289
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036048281207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL473530Medicare PIN