Provider Demographics
NPI:1164281069
Name:SIDHU, VIRPAL KAUR
Entity type:Individual
Prefix:
First Name:VIRPAL
Middle Name:KAUR
Last Name:SIDHU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 N BARRINGTON RD STE 400
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2036
Mailing Address - Country:US
Mailing Address - Phone:815-947-4463
Mailing Address - Fax:
Practice Address - Street 1:2300 N BARRINGTON RD STE 400
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2036
Practice Address - Country:US
Practice Address - Phone:815-947-4463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-14
Last Update Date:2024-10-18
Deactivation Date:2024-04-09
Deactivation Code:
Reactivation Date:2024-06-04
Provider Licenses
StateLicense IDTaxonomies
IL209030048363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health