| Ganapathi Gottumukkala | |
|
6701 159th St Suite B Tinley Park IL 60477-1758 | |
| (708) 614-0893 | |
| (708) 342-1481 |
| Full Name | Ganapathi Gottumukkala |
|---|---|
| Speciality | Family Medicine |
| Location | 6701 159th St, Tinley Park, Illinois |
| Authorized Official Name and Position | Ganapathi Gottumukkala (SOLE PROPRIETOR) |
| Authorized Official Contact | 7086140893 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ganapathi Gottumukkala Po Box 849 Matteson IL 60443-0849 Ph: (708) 747-5850 | Ganapathi Gottumukkala 6701 159th St Suite B Tinley Park IL 60477-1758 Ph: (708) 614-0893 |
| NPI Number | 1962457614 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 11/25/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962457614 | NPI | - | NPPES |
| 01625532 | Other | IL | BCBSIL GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036-074987 (Illinois) | Primary |
Rd Woods Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6800 Centennial Dr, Suite D, Tinley Park, IL 60477 Phone: 170-861-4152 | |
Heart Check America Tinley Park Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9501 171st St Ste Q, Tinley Park, IL 60487 Phone: 708-364-0867 Fax: 708-364-0874 | |
St James Hospital And Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17859 80th Ave, Tinley Park, IL 60477 Phone: 708-709-9600 | |
Ibrahim Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6703 159th St, Suite 105, Tinley Park, IL 60477 Phone: 708-342-1541 Fax: 708-342-2673 | |
Tinley Primary Care, Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17148 Harlem Ave, Tinley Park, IL 60477 Phone: 708-429-1200 Fax: 708-429-4845 | |
David L Ellens Md Facp Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6703 159th St Ste 115, Tinley Park, IL 60477 Phone: 708-342-1573 | |
Comprehensive Physical Medicine, Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6700 167th St, Tinley Park, IL 60477 Phone: 708-429-6061 Fax: 708-429-6092 |