Individual
DR. BHAGYALAKSHMI GOPAL BOGGARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4061 W 95TH ST, OAK LAWN, IL 60453-2611
(630) 961-4150
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036-167214
IL
2084N0400X
Neurology Physician
N3508
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204805001
—
TX
Enumeration date
05/23/2007
Last updated
02/09/2024
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