Individual
DAMAYANTI S HATHIWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3340 OAK PARK AVE, SUITE 201, BERWYN, IL 60402-3420
(708) 795-5502
(708) 795-5516
Mailing address
3340 OAK PARK AVE, SUITE 201, BERWYN, IL 60402-3420
(708) 795-5502
(708) 795-5516
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
36-65246
IL
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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