Individual
DIVYA BAKTHA RAMACHANDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4400 W 95TH ST STE 207, OAK LAWN, IL 60453-2658
(708) 684-1563
Mailing address
4400 W 95TH ST STE 207, OAK LAWN, IL 60453-2658
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
247.000099
IL
Other
Enumeration date
09/08/2017
Last updated
09/08/2017
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