Individual
MANUBOLU DEVANAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(217) 383-3311
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036153036
IL
207RI0200X
Infectious Disease Physician
036.153036
IL
Other
Enumeration date
07/19/2017
Last updated
02/01/2023
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