Organization
BALU NATARAJAN MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BALAKRISHNAN NATARAJAN MD (PRESIDENT)
(312) 616-7778
Entity
Organization
Contact information
Practice address
711 W NORTH AVE, SUITE 208, CHICAGO, IL 60610-7010
(312) 616-7778
(312) 276-4304
Mailing address
711 W NORTH AVE, SUITE 208, CHICAGO, IL 60610-1174
(773) 616-7778
(312) 276-4304
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036101773
IL
207RS0010X
Sports Medicine (Internal Medicine) Physician
036101773
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633302
BLUE CROSS BLUE SHIELD
IL
05
—
036101773
—
IL
Enumeration date
05/29/2007
Last updated
02/19/2016
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