Individual
DR. REZA ALEX GAMAGAMI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1890 SILVER CROSS BLVD, SUITE 410, NEW LENOX, IL 60451-9524
(815) 717-8730
(815) 717-8729
Mailing address
1890 SILVER CROSS BLVD, SUITE 410, NEW LENOX, IL 60451-9524
(815) 717-8730
(815) 717-8729
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-103521
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-103521
—
IL
Enumeration date
12/03/2005
Last updated
01/18/2024
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