Individual
GOUTHAM KONDAPI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9125 S PULASKI RD, EVERGREEN PARK, IL 60805-1441
(708) 422-7715
(708) 422-7816
Mailing address
120 W 22ND ST, OAK BROOK, IL 60523-1557
(630) 573-5000
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036160201
IL
Other
Enumeration date
04/01/2019
Last updated
09/18/2024
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