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Organization
SARAT YALAMANCHILI, MD, SC
Active
Organization
SARAT YALAMANCHILI, MD, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAT YALAMANCHILI MD (DIRECTOR)
(815) 937-4500
Entity
Organization
Contact information
Practice address
1521 N CONVENT ST STE 101, BOURBONNAIS, IL 60914-1469
(815) 937-4500
(815) 937-4777
Mailing address
1521 N CONVENT ST STE 101, BOURBONNAIS, IL 60914-1469
(815) 937-4500
(815) 937-4777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D0960977
CLIA
IL
01
—
4632101
BCBS
IL
01
—
DP5055
RAILROAD MEDICARE
IL
Enumeration date
07/30/2006
Last updated
07/29/2020
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