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Individual

VENKATA BUDDHARAJU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., F.C.C.P.

Contact information

Practice address
840 W IRVING PARK RD, 305, CHICAGO, IL 60613
(773) 975-6775
(773) 975-1089
Mailing address
2180 DE COOK AVE, PARK RIDGE, IL 60068-1538
(773) 505-3071
(773) 975-1089

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-089871
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036089871
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01635515
BCBS
IL
Enumeration date
05/17/2006
Last updated
08/30/2018
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