Organization
V BHOOPAL MD,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VASIREDDY BHOOPAL MD (FAMILY PRACTICE)
(708) 388-4911
Entity
Organization
Contact information
Practice address
12800 S RIDGELAND AVE, SUITE E, PALOS HEIGHTS, IL 60463-2390
(708) 388-4911
(708) 388-4933
Mailing address
12800 S RIDGELAND AVE, SUITE E, PALOS HEIGHTS, IL 60463-2390
(708) 388-4911
(708) 388-4933
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
036056748
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036056748
—
IL
Enumeration date
06/11/2010
Last updated
06/11/2010
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