Individual
DR. PREMAL MADHUKAR TRIVEDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 E CHICAGO AVE, DEPARTMENT OF PEDIATRIC ANESTHESIOLOGY, BOX 19, CHICAGO, IL 60611-2991
(312) 227-5170
Mailing address
225 E CHICAGO AVE, DEPARTMENT OF PEDIATRIC ANESTHESIOLOGY, BOX 19, CHICAGO, IL 60611-2991
(312) 227-5170
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036125926
IL
207LP3000X
Pediatric Anesthesiology Physician
Primary
036125926
IL
Other
Enumeration date
06/16/2007
Last updated
02/26/2013
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