Individual
DR. GHURULAKSHMI MOORTHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M..D
Contact information
Practice address
611 W PARK ST, CARLE FORUM LL, URBANA, IL 61801-2500
(217) 383-3110
(217) 244-0621
Mailing address
611 W PARK ST, CARLE FORUM LL, URBANA, IL 61801-2500
(217) 383-3110
(217) 244-0621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125061906
IL
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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