Individual
DR. VIVEKA BODDIPALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., MBA
Contact information
Practice address
133 E BRUSH HILL RD STE 110, ELMHURST, IL 60126-5659
(630) 946-2996
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036130678
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2009
Last updated
08/04/2023
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