Individual
NANDA KISHORE MADDINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
850 W IRVING PARK RD, CHICAGO, IL 60613-3077
(773) 975-6730
Mailing address
850 W IRVING PARK RD, CHICAGO, IL 60613-3077
(773) 975-6730
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238.000564
IL
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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