Organization
MED MK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYYURATHAN KANAGGAPPAH MAHESWARA (PRESIDENT)
(312) 483-3171
Entity
Organization
Contact information
Practice address
1785 W HOWARD ST, CHICAGO, IL 60626-1626
(312) 483-3171
Mailing address
7120 N SHERIDAN RD APT 304, CHICAGO, IL 60626-2906
(312) 483-3171
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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