Individual
DR. KRISHNA C CHUNDURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6524 W ARCHER AVE, CHICAGO, IL 60638-2400
(773) 717-0890
Mailing address
15W302 60TH ST, BURR RIDGE, IL 60527-5201
(312) 952-2226
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036118198
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036118798
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01638884
BLUE CROSS BLUE SHIELD
IL
05
—
036118798
—
IL
Enumeration date
06/05/2007
Last updated
06/17/2020
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