Individual
ASWATH SUBRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3700 W 203RD ST, #301, OLYMPIA FIELDS, IL 60461-1180
(708) 709-9402
Mailing address
333 DIXIE HWY, CHICAGO HTS, IL 60411-1748
(708) 756-0100
(708) 709-6353
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
01045324A
IN
2086S0129X
Vascular Surgery Physician
Primary
036056131
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036056131
—
IL
Enumeration date
05/31/2006
Last updated
05/10/2024
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