Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
GANAPATHI GOTTUMUKKALA
Active
Organization
GANAPATHI GOTTUMUKKALA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GANAPATHI GOTTUMUKKALA M.D. (SOLE PROPRIETOR)
(708) 614-0893
Entity
Organization
Contact information
Practice address
6701 159TH ST, SUITE B, TINLEY PARK, IL 60477-1758
(708) 614-0893
(708) 342-1481
Mailing address
PO BOX 849, MATTESON, IL 60443-0849
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-074987
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01625532
BCBSIL GROUP #
IL
Enumeration date
05/23/2006
Last updated
11/25/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up