Provider Demographics
NPI:1104316363
Name:MONPARA, POOJA B (MD)
Entity type:Individual
Prefix:
First Name:POOJA
Middle Name:B
Last Name:MONPARA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 W MAXWELL ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-5001
Mailing Address - Country:US
Mailing Address - Phone:312-996-2901
Mailing Address - Fax:312-996-5181
Practice Address - Street 1:722 W MAXWELL ST FL 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-5001
Practice Address - Country:US
Practice Address - Phone:412-414-8198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-14
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036157797207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty