Individual
PRATHIMA KANDUKURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
600 S PAULINA ST, CHICAGO, IL 60612-3806
(888) 352-7874
Mailing address
600 S PAULINA ST, CHICAGO, IL 60612-3806
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
1083316129
TX
208100000X
Physical Medicine & Rehabilitation Physician
Primary
125084576
IL
390200000X
Student in an Organized Health Care Education/Training Program
125084576
IL
Other
Enumeration date
03/21/2023
Last updated
08/05/2024
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