Provider Demographics
NPI:1992818827
Name:JOBANPUTRA, KETAN NARANDAS (MD)
Entity type:Individual
Prefix:DR
First Name:KETAN
Middle Name:NARANDAS
Last Name:JOBANPUTRA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1515 E LAKE ST
Mailing Address - Street 2:208
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-4896
Mailing Address - Country:US
Mailing Address - Phone:630-540-9317
Mailing Address - Fax:630-540-2262
Practice Address - Street 1:1515 WEST LAKE STREET, #208,
Practice Address - Street 2:ALEXIAN BROTHERS' HOSPITAL PAVILION,
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133
Practice Address - Country:US
Practice Address - Phone:630-540-9317
Practice Address - Fax:630-540-2262
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IL036-102289207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology