Individual
SELVAKUMAR KUNCHITHAPATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
908 N ELM ST STE 404, HINSDALE, IL 60521-3638
(630) 789-3422
Mailing address
900 S FRONTAGE RD, SUITE 325, WOODRIDGE, IL 60517-4903
(630) 789-3422
(630) 789-9093
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
036092123
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912218850
NPI GROUP PRACTICE
IL
01
—
IL4174008
MEDICARE-LOCALITY 16
IL
01
—
IL4177008
MEDICARE-LOCALITY 15
IL
Enumeration date
07/23/2006
Last updated
03/22/2021
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