Individual
MANISHA UPADHYAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2900 N LAKE SHORE DR, CHICAGO, IL 60657-5640
(773) 665-3000
Mailing address
108 EAGLE RIDGE DR, CHATHAM, IL 62629-2006
(312) 523-1045
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01085480A
IN
Other
Enumeration date
04/03/2018
Last updated
09/20/2022
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