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Ghanshyam S. Thakkar

Obstetrics & Gynecology

Allopathic & Osteopathic Physicians

1044 N Francisco Ave, Chicago, IL 60622-2743

PECOS Enrollment

This provider is enrolled in PECOS as GHANSHYAM THAKKAR.

Based on the most recent information from CMS, provider Ghanshyam S. Thakkar is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1235196007
Provider Type
Individual
Full Name
Thakkar, Ghanshyam S.
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
4/27/2006
Last Updated
1/27/2026

Contact Information

Practice Location

1044 N Francisco Ave, Chicago, IL 60622-2743

(773) 292-8200

(773) 292-8237

Mailing Location

8558 Broadway, Merrillville, IN 46410-7032

(219) 392-7084

(219) 703-6854

Provider Taxonomies

Code	Description	License
Code 207V00000X Primary	Description Obstetrics & Gynecology Allopathic & Osteopathic Physicians	License 036071876 Illinois
Code 207V00000X	Description Obstetrics & Gynecology Allopathic & Osteopathic Physicians	License 01038856A Indiana

Provider Identifiers

ID	Description	Issuer
ID 036071876	Description Medicaid	Issuer Unlisted Illinois

Ghanshyam S. Thakkar

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Thompson, Keona Denise Marie

Arekapudi, Vijayalakshmi

Bohorquez, Marlon E

Cueva, Shirley

Gogawale, Puja Sheth

Ayuste, Hermes

Ewbank, Andrew

Sisco, Katherine M

Lee, Andrea

Roldan, Mario A