Provider Demographics
NPI:1760584569
Name:GIRI, NIRANJANA K (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRANJANA
Middle Name:K
Last Name:GIRI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8319 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-1605
Mailing Address - Country:US
Mailing Address - Phone:708-452-4800
Mailing Address - Fax:708-450-9965
Practice Address - Street 1:8319 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-1605
Practice Address - Country:US
Practice Address - Phone:708-452-4800
Practice Address - Fax:708-450-9965
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0031600879OtherBLUE CROSS BLUE SHIELD
IL0031600879OtherBLUE CROSS BLUE SHIELD