Individual
SUSHAMA GUNDLAPALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1243 RICKERT DR, NAPERVILLE, IL 60540-0954
(630) 527-6450
(630) 527-6456
Mailing address
1243 RICKERT DR, NAPERVILLE, IL 60540-0954
(630) 527-6450
(630) 527-6456
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036-106014
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036106014
—
IL
01
—
P00358682
MEDICARE RAILROAD
IL
Enumeration date
06/05/2006
Last updated
09/23/2011
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