Individual
REENI M KARAVATTUVEETIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(708) 783-2696
(708) 783-3164
Mailing address
3249 S. OAK PARK AVE., BERWYN, IL 60402
(708) 783-2696
(708) 783-3164
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-093026
IL
2085R0202X
Diagnostic Radiology Physician
35.091684
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093026 2
—
IL
01
—
300109919
RR MEDICARE
IL
Enumeration date
06/05/2006
Last updated
05/21/2008
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