Kishor G Ajmere, MD
Individual provider Active NPI Internal Medicine Physician · Joliet, IL
NPI 1144239369 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1144239369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Practice address
- 2435 Glenwood Ave
Ste 110
Joliet, IL 60435-5461 - Phone
- (815) 744-6005
- Fax
- (815) 744-6023
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-052843 | IL | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | IL | Yes |
Addresses
Primary practice location
2435 Glenwood Ave
Ste 110
Joliet, IL 60435-5461
Mailing address
2435 Glenwood Ave
Ste 110
Joliet, IL 60435-5461
Phone (815) 744-6005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9900432 | Other | IL | BC/BS OF ILLINOIS |
Other providers in Joliet, IL
- Mohammed N. Ahmed
- Naila I Ahmed
- Sung Chul Ahn
- Aim Psychological Services Corp
- Midhun Ajikumar
- Sabah Akbar
- Matheena Akhtar
- Mojisola Abayemi Akinfe
- Becky Akosah
- Hazem Al Muradi
All providers in Joliet, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.