Individual
DR. MANJULA DUNDOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527
(888) 220-6432
(630) 654-4253
Mailing address
901 MCCLINTOCK DR, SUITE 202, BURR RIDGE, IL 60527-0872
(888) 220-6432
(630) 654-4253
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036117101
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-117101
ILLINOIS LICENSE
IL
05
—
036117101
—
IL
01
—
206147
MEDICARE GRP PTAN
IL
01
—
F400314859
MEDICARE INDIV PTAN
IL
Enumeration date
12/01/2006
Last updated
08/31/2018
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