Individual
DR. PUJA KARANTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12251 S 80TH AVE, PALOS HEIGHTS, IL 60463-1256
(708) 923-5869
(708) 923-5859
Mailing address
12251 S 80TH AVE, SUITE 1630, PALOS HEIGHTS, IL 60463-1256
(708) 923-5173
(708) 923-5018
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.139452
IL
208M00000X
Hospitalist Physician
Primary
036.139452
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036139452
—
IL
01
—
F400384251
MEDICARE PTAN
IL
Enumeration date
07/28/2011
Last updated
11/29/2021
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