Individual
LAKSHMI ANUBROLU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 W HIGH ST, MORRIS, IL 60450-1497
(815) 942-2932
(815) 416-6097
Mailing address
725 SCHOOL ST STE A, MORRIS, IL 60450-1207
(815) 941-9124
(815) 941-4363
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036113201
IL
207R00000X
Internal Medicine Physician
Primary
036.113201
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089724
—
IL
05
—
036113201
—
IL
01
—
P00452387
RR MEDICARE
IL
Enumeration date
03/15/2006
Last updated
12/21/2020
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