Individual
DR. S. CHANDRA MOULI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
675 W NORTH AVE, SUITE 402, MELROSE PARK, IL 60160-1634
(708) 681-7888
Mailing address
655 DEERFIELD RD, SUITE 100 PMB 418, DEERFIELD, IL 60015-3241
(708) 667-4333
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-048776
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-048776
—
IL
Enumeration date
07/07/2006
Last updated
09/08/2008
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