Mullapudi Medical Llc | |
2s607 Vendome Ave Oak Brook IL 60523-1073 | |
(630) 926-5409 | |
Not Available |
Full Name | Mullapudi Medical Llc |
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Speciality | Internal Medicine |
Location | 2s607 Vendome Ave, Oak Brook, Illinois |
Authorized Official Name and Position | Rajendra P Mullapudi (OWNER) |
Authorized Official Contact | 6309265409 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mullapudi Medical Llc 2s607 Vendome Ave Oak Brook IL 60523-1073 Ph: (630) 926-5409 | Mullapudi Medical Llc 2s607 Vendome Ave Oak Brook IL 60523-1073 Ph: (630) 926-5409 |
NPI Number | 1336434687 |
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Provider Enumeration Date | 06/15/2011 |
Last Update Date | 06/15/2011 |
Medicare PECOS PAC ID | 5597935205 |
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Medicare Enrollment ID | O20110906000625 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336434687 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036119143 (Illinois) | Primary |
Provider Name | Rajendra P Mullapudi |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1679764096 PECOS PAC ID: 7113012030 Enrollment ID: I20071005000745 |
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