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Organization
SOUTHWEST MEDICAL CONSULTANTS, S.C.
Active
Organization
SOUTHWEST MEDICAL CONSULTANTS, S.C.
Active
Parent organization
SOUTHWEST MEDICAL CONSULTANTS, S.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHWEST MEDICAL CONSULTANTS, S.C.
Authorized official
S VENKATARAMAN MD (PRESIDENT)
(708) 636-1818
Entity
Organization
Contact information
Practice address
6853 KINGERY HWY, WILLOWBROOK, IL 60527-5114
(630) 230-0510
Mailing address
PO BOX 388320, CHICAGO, IL 60638-8320
(773) 767-8283
(773) 767-8320
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036046355
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211195
MEDICARE
IL
01
—
31601474
BLUE SHIELD
IL
01
—
6012510001
DMERC
IL
Enumeration date
09/28/2007
Last updated
12/31/2021
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