Individual
DR. TALENTSHIA VETHANAYAGAMONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-1084
Mailing address
218 S CRANBERRY ST, BOLINGBROOK, IL 60490-2063
(630) 226-0825
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
125059362
IL
Other
Enumeration date
09/21/2011
Last updated
07/06/2012
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