| Bala Kanagaraju, M.d.s.c | |
|
7914 S Ashland Ave Chicago IL 60620-4335 | |
| (773) 651-6800 | |
| Not Available |
| Full Name | Bala Kanagaraju, M.d.s.c |
|---|---|
| Speciality | General Practice |
| Location | 7914 S Ashland Ave, Chicago, Illinois |
| Authorized Official Name and Position | Bala R Kanagaraju (OWNER) |
| Authorized Official Contact | 7087990234 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bala Kanagaraju, M.d.s.c 1807 Vollmer Rd Flossmoor IL 60422-1960 Ph: (708) 799-0234 | Bala Kanagaraju, M.d.s.c 7914 S Ashland Ave Chicago IL 60620-4335 Ph: (773) 651-6800 |
| NPI Number | 1295050821 |
|---|---|
| Provider Enumeration Date | 04/07/2010 |
| Last Update Date | 04/07/2010 |
| Medicare PECOS PAC ID | 9335276468 |
|---|---|
| Medicare Enrollment ID | O20100422000106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295050821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Bala Kanagaraju |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851315469 PECOS PAC ID: 3870620909 Enrollment ID: I20100422000131 |
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