| Bapushetty Madoori Md Sc | |
|
6905 S Wentworth Ave Chicago IL 60621-3734 | |
| (708) 590-9805 | |
| Not Available |
| Full Name | Bapushetty Madoori Md Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6905 S Wentworth Ave, Chicago, Illinois |
| Authorized Official Name and Position | Bapushetty Madoori (PRESIDENT) |
| Authorized Official Contact | 7085909805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bapushetty Madoori Md Sc 15617 Sunset Ridge Dr Orland Park IL 60462-4925 Ph: (708) 590-9805 | Bapushetty Madoori Md Sc 6905 S Wentworth Ave Chicago IL 60621-3734 Ph: (708) 590-9805 |
| NPI Number | 1508018326 |
|---|---|
| Provider Enumeration Date | 10/13/2008 |
| Last Update Date | 10/13/2008 |
| Medicare PECOS PAC ID | 9234298928 |
|---|---|
| Medicare Enrollment ID | O20081110000820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508018326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036057250 (Illinois) | Primary |
| Provider Name | Bapushetty R Madoori |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083797864 PECOS PAC ID: 1052470739 Enrollment ID: I20081110000817 |
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