Organization
BAPUSHETTY MADOORI MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAPUSHETTY MADOORI M.D. (PRESIDENT)
(708) 590-9805
Entity
Organization
Contact information
Practice address
6905 S WENTWORTH AVE, CHICAGO, IL 60621-3734
(708) 590-9805
Mailing address
15617 SUNSET RIDGE DR, ORLAND PARK, IL 60462-4925
(708) 590-9805
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036057250
IL
Other
Enumeration date
10/13/2008
Last updated
10/13/2008
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