Provider Demographics
NPI:1700879178
Name:SODHI, BRIJNANDAN SINGH (MD)
Entity Type:Individual
Prefix:MR
First Name:BRIJNANDAN
Middle Name:SINGH
Last Name:SODHI
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 1:1010 W CLAY ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-4368
Mailing Address - Country:US
Mailing Address - Phone:217-431-7200
Mailing Address - Fax:217-431-8000
Practice Address - Street 1:1010 W CLAY ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4368
Practice Address - Country:US
Practice Address - Phone:217-431-7200
Practice Address - Fax:217-431-8000
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL225521Medicare PIN
C44989Medicare UPIN