Provider Demographics
NPI:1629238746
Name:GUGNANI, SHALU P (MD)
Entity Type:Individual
Prefix:DR
First Name:SHALU
Middle Name:P
Last Name:GUGNANI
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 1:901 W KIRCHHOFF RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2361
Mailing Address - Country:US
Mailing Address - Phone:847-618-2700
Mailing Address - Fax:
Practice Address - Street 1:901 W KIRCHHOFF RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2361
Practice Address - Country:US
Practice Address - Phone:847-618-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63063-20207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine