Individual
NAGENDRA POLAVARAPU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4440 W 95TH ST STE 3192H, OAK LAWN, IL 60453-2600
(708) 684-5685
(708) 684-4712
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-119683
IL
2080P0203X
Pediatric Critical Care Medicine Physician
036119683
IL
2080P0203X
Pediatric Critical Care Medicine Physician
38700
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036119683
—
IL
Enumeration date
02/01/2007
Last updated
02/20/2023
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