Organization
SOUTHWEST MEDICAL CONSULTANTS, S.C.
Active
Parent organization
SOUTHWEST MEDICAL CONSULTANTS, S.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHWEST MEDICAL CONSULTANTS, S.C.
Authorized official
S VENKATARAMAN MD (PRESIDENT)
(708) 636-1818
Entity
Organization
Contact information
Practice address
6853 KINGERY HWY, WILLOWBROOK, IL 60527-5114
(630) 230-0510
Mailing address
PO BOX 388320, CHICAGO, IL 60638-8320
(773) 767-8283
(773) 767-8320
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
036046355
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211195
MEDICARE
IL
01
—
31601474
BLUE SHIELD
IL
01
—
6012510001
DMERC
IL
Enumeration date
09/28/2007
Last updated
12/31/2021
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