Dhanalakshmi P. Ganesan M.D.S.C

Organization Active NPI Internal Medicine Physician · River Forest, IL

NPI 1144382201 · NPPES record last updated Nov 14, 2011

Key facts

NPI
1144382201
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
License
042-617802 (IL)
Legal business name
DHANALAKSHMI P. GANESAN M.D.S.C
Practice address
7357 North Ave
River Forest, IL 60305-1230
Phone
(708) 405-6200
Fax
(708) 405-6223
NPI assigned
Dec 15, 2006
Organization subpart
Yes
Parent organization (as reported)
DHANALAKSHMI P. GANESAN M.D.S.C

Authorized official

Name
Dr. Dhana L Ganesan, M.D
Title
Physician
Phone
(708) 405-6200

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Part of
Dhanalakshmi P Ganesan MDSC

Locations

11714 S Western Ave
Chicago, IL 60643
Phone (708) 456-7071

7239 W Grand Ave
Elmwood Park, IL 60707
Phone (708) 453-3464

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X 042-617802 IL Yes

Addresses

Primary practice location

7357 North Ave
River Forest, IL 60305-1230

Mailing address

7357 North Ave
River Forest, IL 60305-1230
Phone (708) 405-6200

Other identifiers

IdentifierTypeStateIssuer
036094637MedicaidIL

Other providers in River Forest, IL

All providers in River Forest, IL · Internal Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.