Provider Demographics
NPI:1386876183
Name:DR. RAJA GILL SC
Entity type:Organization
Organization Name:DR. RAJA GILL SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-632-5612
Mailing Address - Street 1:1127 S MANNHEIM RD
Mailing Address - Street 2:116
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-2570
Mailing Address - Country:US
Mailing Address - Phone:708-632-5612
Mailing Address - Fax:
Practice Address - Street 1:1127 S MANNHEIM RD
Practice Address - Street 2:116
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2570
Practice Address - Country:US
Practice Address - Phone:708-632-5612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty