Individual
DR. MITRA SADRAMELI
Active
Individual
DR. MITRA SADRAMELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
019.030434
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019.030434
STATE OF ILLINOIS, DEPARTMENT OF FINANCIAL & PROFESSIONAL REGULATION
IL
Enumeration date
01/24/2016
Last updated
01/24/2016
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