Provider Demographics
NPI:1184061335
Name:GOKUL INC
Entity type:Organization
Organization Name:GOKUL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARSHNA
Authorized Official - Middle Name:D
Authorized Official - Last Name:VYAS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN
Authorized Official - Phone:847-340-8808
Mailing Address - Street 1:27 PRAIRIE POINTE LN
Mailing Address - Street 2:
Mailing Address - City:STREAMWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60107-2356
Mailing Address - Country:US
Mailing Address - Phone:847-340-8808
Mailing Address - Fax:
Practice Address - Street 1:27 PRAIRIE POINTE LN
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-2356
Practice Address - Country:US
Practice Address - Phone:847-340-8808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164004292133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty