Individual
KIRANMAI GORLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1675 DEMPSTER ST, PARK RIDGE, IL 60068-1110
(847) 723-7700
(847) 723-9418
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1110
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
036126977
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036126977
—
IL
Enumeration date
06/13/2007
Last updated
09/19/2022
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