Individual
VIJAY RAJ KURUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(410) 370-7126
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(410) 370-7126
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
125.084404
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2024
Last updated
08/15/2024
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