Individual
RAJITHA LAKSHMI AVVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
PALOS BEHAVIORAL HEALTH, 13011 S 104TH AVE, PALOS PARK, IL 60464
(708) 448-3300
Mailing address
12615 SUFFIELD DRIVE, PALOS PARK, IL 60464
(708) 448-0161
(708) 362-3766
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01623882
BC BS
IL
Enumeration date
01/22/2007
Last updated
07/08/2007
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