Individual
DR. THENMATHI SIVARAJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14735 S PULASKI, MIDLOTHIAN, IL 60445
(708) 371-0077
(708) 597-7714
Mailing address
14735 S PULASKI, MIDLOTHIAN, IL 60445
(708) 371-0077
(708) 597-7714
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036063023
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036063023
—
IL
Enumeration date
05/23/2006
Last updated
01/07/2015
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