Provider Demographics
NPI:1760597017
Name:SINGH, MANVINDER (MD)
Entity Type:Individual
Prefix:MR
First Name:MANVINDER
Middle Name:
Last Name:SINGH
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 1:6319 S FAIRVIEW
Mailing Address - Street 2:S 101
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559
Mailing Address - Country:US
Mailing Address - Phone:630-852-5017
Mailing Address - Fax:630-852-1474
Practice Address - Street 1:6319 S FAIRVIEW
Practice Address - Street 2:S 101
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559
Practice Address - Country:US
Practice Address - Phone:630-852-5017
Practice Address - Fax:630-852-1474
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036061574207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL110007365BOtherRR MEDICARE PROVIDER #
IL110007365BOtherRR MEDICARE PROVIDER #
ILK49341Medicare PIN