Provider Demographics
NPI:1013958388
Name:GARG, ASHWANI KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHWANI
Middle Name:KUMAR
Last Name:GARG
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 1:908 N ELM ST STE 202
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3637
Mailing Address - Country:US
Mailing Address - Phone:630-861-6663
Mailing Address - Fax:
Practice Address - Street 1:908 N ELM ST STE 202
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3637
Practice Address - Country:US
Practice Address - Phone:630-861-6663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108096207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036108096Medicaid
IL5483195OtherCCN
IL21244725985OtherBEECH STREET
IL7550278OtherCIGNA
IL7090488OtherAETNA
IL200147854AOtherHUMANA
IL1633858OtherBCBSIL
IL2213529OtherFIRST HEALTH
IL7090488OtherAETNA
IL2213529OtherFIRST HEALTH
IL21244725985OtherBEECH STREET
ILK08625Medicare ID - Type UnspecifiedPIN KANE COUNTY
IL209585Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER