Individual
VASANTHA NAIDU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
654 E 47TH ST, CHICAGO, IL 60653-4224
(773) 624-4800
(773) 624-5028
Mailing address
654 E 47TH ST, CHICAGO, IL 60653-4224
(773) 624-4800
(773) 624-5028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-056679
IL
208000000X
Pediatrics Physician
Primary
036-056679
IL
Other
Enumeration date
12/20/2006
Last updated
05/14/2012
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