Individual
MRS. SHOBHANA PATODIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 SUPERIOR STREET, SUITE 206, MELROSE PARK, IL 60160
(708) 338-9387
Mailing address
1111 SUPERIOR ST, SUITE 206, MELROSE PARK, IL 60160
(708) 338-9397
(708) 338-9389
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036054216
IL
208VP0014X
Interventional Pain Medicine Physician
Primary
036054216
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01607050
BCBS
—
05
—
036054216
—
IL
01
—
050058531
RRM
—
Enumeration date
07/05/2006
Last updated
01/19/2010
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