Organization
MIDWEST GASTROENTEROLOGY ASSOCIATES LTD
Active
Organization
MIDWEST GASTROENTEROLOGY ASSOCIATES LTD
Active
Other names
Midwest Gastro Ltd
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DHRUVA TILWALLI MD (PRESIDENT)
(630) 827-0100
Entity
Organization
Contact information
Practice address
17 W 755 BUTTERFIELD RD, SUITE 101, OAKBROOK TERRACE, IL 60181
(630) 827-0100
(630) 827-0103
Mailing address
17 W 755 BUTTERFIELD RD, SUITE 101, OAKBROOK TERRACE, IL 60181
(630) 827-0100
(630) 827-0103
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21608842
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/08/2007
Last updated
05/07/2008
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