Individual
LEELA BHUPALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
PO BOX 950237, LOUISVILLE, KY 40295-0237
(502) 238-2801
(502) 238-2835
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036172447
IL
207RH0003X
Hematology & Oncology Physician
29062
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000652541
ANTHEM
KY
01
—
3770175000
PASSPORT ADVANTAGE
KY
01
—
50027633
PASSPORT
KY
05
—
64290620
—
KY
Enumeration date
11/09/2005
Last updated
01/16/2025
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