Organization
KANCHANA ESARIYA UMPAI,MD,SC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KANCHANA ESARIYA UMPAI M.D. (PRESIDENT)
(815) 744-2556
Entity
Organization
Contact information
Practice address
1026 ESSINGTON RD, JOLIET, IL 60435-2841
(815) 744-2556
(815) 744-3554
Mailing address
1026 ESSINGTON RD, JOLIET, IL 60435-2841
(815) 744-2556
(815) 744-3554
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036060991
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036060991
—
IL
Enumeration date
04/22/2008
Last updated
05/01/2012
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