Individual
DR. BHARGAV MUDDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 S. SCHMIDT ROAD, STE. 240, BOLINGBROOK, IL 60440-2634
(630) 312-4505
(630) 312-6651
Mailing address
1120 W AVENUE M4, PALMDALE, CA 93551-1432
(661) 480-2377
(661) 480-2378
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036143270
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036143270
IL
261QM1300X
Multi-Specialty Clinic/Center
036143270
IL
Other
Enumeration date
06/04/2012
Last updated
10/01/2021
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