Provider Demographics
NPI:1245734854
Name:GURURANGAN, KAPIL (MD)
Entity type:Individual
Prefix:DR
First Name:KAPIL
Middle Name:
Last Name:GURURANGAN
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 1:259 E ERIE ST STE 1900
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3246
Mailing Address - Country:US
Mailing Address - Phone:312-695-7950
Mailing Address - Fax:312-695-5747
Practice Address - Street 1:259 E ERIE ST STE 1900
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3246
Practice Address - Country:US
Practice Address - Phone:312-695-7950
Practice Address - Fax:312-695-5747
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1714642084E0001X
CAA1786522084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsyGroup - Multi-Specialty