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Individual

DR. PRABHAVATHI MARIYAPPA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1901 W HARRISON ST, JOHN H. STROGER JR. HOSPITAL, DEPARTMENT OF PEDIATRICS, CHICAGO, IL 60612-3714
(312) 864-1523
Mailing address
1535 S MONTEREY AVE, VILLA PARK, IL 60181-3434
(630) 832-4159

Taxonomy

Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
IL

Other

Enumeration date
06/23/2006
Last updated
07/08/2007
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