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Organization
JAYANTHI RAMADURAI MD SC
Active
Organization
JAYANTHI RAMADURAI MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAYANTHI R RAMADURAI MD (PRESIDENT/OWNER)
(847) 692-6218
Entity
Organization
Contact information
Practice address
4901 W 79TH ST, SUITE 2-3, BURBANK, IL 60459-1554
(708) 636-1177
(708) 636-8741
Mailing address
PO BOX 798, PARK RIDGE, IL 60068-0798
(847) 692-6218
(847) 692-5609
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360738093
—
IL
01
—
216-22939
BC BS
—
Enumeration date
08/13/2006
Last updated
03/07/2008
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