Individual
ADITI PURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(708) 783-6566
(708) 783-6567
Mailing address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036143028
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1028219280001
—
PA
Enumeration date
05/20/2010
Last updated
05/24/2022
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