Individual
MOHANLAL WICKRAMASINGHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3450 S ARCHER AVE, CHICAGO, IL 60608-6837
(773) 523-1000
(773) 843-1553
Mailing address
3450 S ARCHER AVE, CHICAGO, IL 60608-6837
(773) 523-1000
(773) 843-1553
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-047140
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036047140
—
IL
Enumeration date
06/07/2006
Last updated
06/07/2012
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