Individual
DR. KAVITHA BATHALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6703 159TH ST, SUITE 110, TINLEY PARK, IL 60477-1781
(708) 444-8282
Mailing address
PO BOX 1119, MATTESON, IL 60443-4119
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036106265
IL
Other
Enumeration date
07/25/2006
Last updated
12/31/2012
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