Individual
DR. LEKSHMI R VENUGOPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3805 E MAIN ST STE M, ST CHARLES, IL 60174-2487
(630) 646-5200
(630) 377-3762
Mailing address
3805 E MAIN ST STE M, ST CHARLES, IL 60174-2487
(630) 646-5200
(630) 377-3762
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-118180
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118180 1
—
IL
01
—
2220936
BCBS
IL
Enumeration date
06/10/2008
Last updated
04/12/2021
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