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NPI Code Detail

MEDICARE: PRAGATHI CHALLA MD

MEDICARE: PRAGATHI CHALLA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036081329IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033116066
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRAGATHI CHALLA MD
Provider Business Mailing Address
First Line : PO BOX 713260
Second Line :
City : CHICAGO
State : IL
Zip : 60677-1260
Country : US
Telephone Number : 630-469-9200
Fax Number :
Provider Business Practice Location Address
First Line : 14741 S RAVINIA AVE
Second Line :
City : ORLAND PARK
State : IL
Zip : 60462-3100
Country : US
Telephone Number : 708-226-8125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 08/04/2023

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