Individual
DR. NIVEDITHA RAJAGOPALAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1501 IL-50, BOURBONNAIS, IL 60914
(815) 348-9281
Mailing address
1501 IL-50, BOURBONNAIS, IL 60914
(815) 348-9281
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.030828
IL
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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