Organization
KIRAN POLAVARAPU MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRAN POLAVARAPU M.D. (PHYSICIAN)
(773) 710-6128
Entity
Organization
Contact information
Practice address
2348 N LISTER AVE, 305, CHICAGO, IL 60614-2994
(773) 710-6128
Mailing address
2348 N LISTER AVE, 305, CHICAGO, IL 60614-2994
(773) 710-6128
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036126768
IL
Other
Enumeration date
05/12/2011
Last updated
05/12/2011
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