Individual
DR. BANGARUSWAMY CHANDRAMOULI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
920 S DAMEN AVE, CHICAGO, IL 60612-3730
(312) 569-6435
Mailing address
1521 FORDHAM CT, NAPERVILLE, IL 60565-2914
(630) 778-1749
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
18999
NE
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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