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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