Organization
DUPAGE INTERNAL MEDICINE OF ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRABHU SHIVALINGAPPA M.D. (PRESIDENT)
(630) 323-7833
Entity
Organization
Contact information
Practice address
534 CHESTNUT DR, SUITE 210, HINSDALE, IL 60521-3527
(630) 323-7833
(630) 323-7410
Mailing address
40 S CLAY ST STE 210W, HINSDALE, IL 60521-8805
(630) 323-7833
(630) 323-7410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087760
—
IL
Enumeration date
05/17/2007
Last updated
07/22/2019
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