Gamagami, Reza Alex

Gamagami, Reza Alex is an sole proprietor health care provider with primary practice located at 1890 Silver Cross Blvd Suite 410, New Lenox IL 60451-9524. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Gamagami, Reza Alex can be contacted via phone (815) 717-8730.

Contact Information

Primary practice address
1890 Silver Cross Blvd Suite 410 New Lenox IL 60451-9524
Phone: (815) 717-8730
Fax: (815) 717-8729
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036-103521 Illinois

Profile Details

NPI number 1275517153
LBN Legal business name Gamagami, Reza Alex
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 3rd, 2005
Last updated Jan 18th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275517153 NPPES
Illinois MEDICAID 036-103521

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