Organization
SUBBA RAO MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUBBA RAO M.D. (PRESIDENT)
(630) 887-7073
Entity
Organization
Contact information
Practice address
17850 KEDZIE AVE, SUITE 3000, HAZEL CREST, IL 60429-2058
(708) 798-7878
(630) 887-9566
Mailing address
PO BOX 22, HINSDALE, IL 60522-0022
(630) 887-7073
(630) 887-9566
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021606711
BLUE CROSS
IL
05
—
036047207
—
IL
Enumeration date
07/28/2008
Last updated
07/02/2009
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