Individual
SREYA PALLATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4542 W 95TH ST, OAK LAWN, IL 60453-2627
(708) 425-0522
Mailing address
4542 W 95TH ST, OAK LAWN, IL 60453-2627
(708) 425-0522
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036106563
IL
207RN0300X
Nephrology Physician
Primary
036-106563
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036106563
—
IL
Enumeration date
06/26/2006
Last updated
12/09/2021
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