Individual
NAVEEN TIPIRNENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7435 W TALCOTT AVE, CHICAGO, IL 60631-3707
(773) 792-5177
(773) 792-7926
Mailing address
1015 S MERCER AVE, BLOOMINGTON, IL 61701-7107
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036118887
IL
207L00000X
Anesthesiology Physician
227945
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
036118887
IL
208VP0014X
Interventional Pain Medicine Physician
Primary
036118887
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118887
—
IL
01
—
P00411152
RAILROAD MEDICARE
IL
Enumeration date
09/22/2006
Last updated
12/18/2013
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