Individual
SWABNA K SHANMUGIAVELAYUTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE # 1, MAYWOOD, IL 60153-3328
(630) 335-1652
Mailing address
3333 GREEN BAY RD, NORTH CHICAGO, IL 60064-3037
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125077109
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
04/30/2019
Last updated
08/21/2022
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