Individual
MRS. AMITHA MUSHYAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
360 STATION DR, CRYSTAL LAKE, IL 60014
(815) 338-6600
(815) 455-8044
Mailing address
360 STATION DR, CRYSTAL LAKE, IL 60014-7978
(815) 338-6600
(815) 455-8044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036120455
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036120455
STATE LICENSE
IL
05
—
036120455-1
—
IL
05
—
1972729283
—
MO
Enumeration date
04/17/2007
Last updated
10/19/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us