Individual
AHANTH VEDANTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1943 S MANNHEIM RD, WESTCHESTER, IL 60154-4322
(773) 665-3000
Mailing address
2619 W BERWYN AVE APT 3, CHICAGO, IL 60625-3359
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016006047
IL
Other
Enumeration date
03/28/2021
Last updated
04/24/2024
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