Individual
SWARNA GUMMADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 TELSER RD UNIT 1057, LAKE ZURICH, IL 60047-3647
(847) 847-1393
Mailing address
62 KETTELL AVE, YONKERS, NY 10704-2211
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041541780
IL
163WP2201X
Ambulatory Care Registered Nurse
RN2348431
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
209027141
IL
Other
Enumeration date
11/21/2022
Last updated
08/20/2023
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