Individual
KAVITHA VELLANKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE BLDG 102, MAYWOOD, IL 60153-3328
(708) 216-3306
Mailing address
2160 S 1ST AVE, BLDG 102, ROOM 3661, MAYWOOD, IL 60153-3328
(708) 216-3306
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036118585
IL
Other
Enumeration date
06/19/2008
Last updated
06/24/2021
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