Individual
SHILPA PUPPALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657
(773) 296-7820
(773) 296-7821
Mailing address
PO BOX 31455, WALNUT CREEK, CA 94598-8455
(925) 296-7150
(925) 296-7171
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036113036
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113036
—
IL
Enumeration date
10/12/2006
Last updated
09/10/2015
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