Active NPI
Mahesh K Agarwal MD SC
- Pulmonary Disease Physician
- Gurnee, IL
National Provider Identifier
1629065057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 036044722
- Legal business name
- MAHESH K AGARWAL MD SC
- Practice address
- 200 S Greenleaf St
Suite G
Gurnee, IL 60031-3398 - Phone
- (847) 662-5100
- Fax
- (847) 662-5112
- NPI assigned
- Sep 30, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mahesh K Agrawal, MD
- Title
- President
- Phone
- (847) 662-5100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 036044722 | IL | Primary |
Addresses
Primary practice location
200 S Greenleaf St
Suite G
Gurnee, IL 60031-3398
Mailing address
200 S Greenleaf St
Suite G
Gurnee, IL 60031-3398
Phone (847) 662-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036044722 | Medicaid | IL |
National Provider Directory
National Provider DirectoryLocations
200 S Greenleaf St
Ste G
Gurnee, IL 60031
Phone (847) 263-6073
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pulmonary Disease Physician
- Gurnee, IL
- NPI 1730238874
-
- Podiatrist
- Park City, IL
- NPI 1891788139
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128038400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1264723200000",
"number": "1629065057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 S GREENLEAF ST",
"address_2": "SUITE G",
"city": "GURNEE",
"state": "IL",
"postal_code": "600313398",
"telephone_number": "847-662-5100",
"fax_number": "847-662-5112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S GREENLEAF ST",
"address_2": "SUITE G",
"city": "GURNEE",
"state": "IL",
"postal_code": "600313398",
"telephone_number": "847-662-5100",
"fax_number": "847-662-5112"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAHESH K AGARWAL MD SC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-30",
"last_updated": "2010-01-29",
"status": "A",
"authorized_official_last_name": "AGRAWAL",
"authorized_official_first_name": "MAHESH",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "847-662-5100",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IL",
"license": "036044722",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036044722",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gurnee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.