Individual
LOLICHANDRA KADIYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 W CALENDAR AVE, L, LA GRANGE, IL 60525-2325
(516) 353-7734
(708) 578-2408
Mailing address
35318 EAGLE WAY, CHICAGO, IL 60678-0353
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036.126998
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036128998
—
IL
Enumeration date
02/21/2011
Last updated
03/16/2021
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