Organization
VASANTHA KUMARAIAH,MD,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VASANTHA KUMARAIAH MD (OFFICER)
(708) 532-5500
Entity
Organization
Contact information
Practice address
17732 OAK PARK AVE, SUITE E, TINLEY PARK, IL 60477-3934
(708) 532-5500
(708) 532-5525
Mailing address
17732 OAK PARK AVE, SUITE E, TINLEY PARK, IL 60477-3934
(708) 532-5500
(708) 532-5525
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036048395
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036048395
—
IL
Enumeration date
06/12/2008
Last updated
06/12/2008
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