Individual
DIPANKAR MUKHOPADHYAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5101 WILLOW SPRINGS RD, FAMILY PRACTICE RESIDENCY, LA GRANGE, IL 60525-2600
(708) 245-8900
(708) 245-5615
Mailing address
5101 WILLOW SPRINGS RD, FAMILY PRACTICE RESIDENCY, LA GRANGE, IL 60525-2600
(708) 245-8900
(708) 245-5615
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036045296
IL
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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