Provider Demographics
NPI:1063724664
Name:KOCHAR, KUNAL (MD)
Entity type:Individual
Prefix:
First Name:KUNAL
Middle Name:
Last Name:KOCHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1550 N NORTHWEST HWY
Mailing Address - Street 2:STE 107
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1458
Mailing Address - Country:US
Mailing Address - Phone:847-759-1110
Mailing Address - Fax:847-759-8273
Practice Address - Street 1:1550 N NORTHWEST HWY STE 107
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1458
Practice Address - Country:US
Practice Address - Phone:847-759-1110
Practice Address - Fax:847-759-8273
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125058535208600000X
IL036130751208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgery