Individual
BINDIGANAVLE G SHREENIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6084 S ARCHER AVE, CHICAGO, IL 60638-2747
(773) 884-4152
(773) 884-4167
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036053085
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036053085
—
IL
01
—
11024172
RAIL ROAD MEDICARE
IL
01
—
21608591
BCBS PROVIDER ID
IL
Enumeration date
11/01/2006
Last updated
08/25/2008
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