Individual
NAGAMANI PAVULURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1165 N CLARK ST STE 700, CHICAGO, IL 60610-2821
(312) 996-7723
Mailing address
30 W OAK ST APT 14A, CHICAGO, IL 60610-8724
(312) 996-7723
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036101082
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101082
—
IL
Enumeration date
08/13/2006
Last updated
05/23/2024
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