Organization
BALAMOORTI GAONKAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY RADY (BILLING SPECIALIST)
(847) 429-0571
Entity
Organization
Contact information
Practice address
6 DOUGLAS AVE, ELGIN, IL 60120-5546
(847) 429-0570
Mailing address
6 DOUGLAS AVE, ELGIN, IL 60120-5546
(847) 429-0570
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
05/11/2011
Last updated
05/11/2011
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