Individual
PRASHANTH RAVIKIRAN TAMRAGOURI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1909 OGDEN AVE STE A, DOWNERS GROVE, IL 60515-2602
(630) 750-7920
Mailing address
1909 OGDEN AVE STE A, DOWNERS GROVE, IL 60515-2602
(630) 750-7920
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036138017
IL
2084P0805X
Geriatric Psychiatry Physician
036138017
IL
Other
Enumeration date
04/05/2012
Last updated
12/29/2017
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