Provider Demographics
NPI:1922619022
Name:HEALTHGEN LLC
Entity Type:Organization
Organization Name:HEALTHGEN LLC
Other - Org Name:HEALTHGEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PUNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:GREWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD, CARDIOLOGIST
Authorized Official - Phone:312-598-2090
Mailing Address - Street 1:1401 DARIEN CLUB DR
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-3670
Mailing Address - Country:US
Mailing Address - Phone:312-598-2090
Mailing Address - Fax:
Practice Address - Street 1:222 MERCHANDISE MART PLZ STE 1212
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-4342
Practice Address - Country:US
Practice Address - Phone:312-598-2090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-12
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service