Individual
TARUNA WAGHRAY-PENMETCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(312) 864-1903
Mailing address
7810 CIRCLE DR, BURR RIDGE, IL 60527-8011
(630) 662-0393
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036-106874
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036-106874
IL
Other
Enumeration date
03/28/2007
Last updated
05/04/2021
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