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NPI Code Detail

MEDICARE: DR. ANISHA MOHAN MURARKA DDS

MEDICARE:  DR. ANISHA MOHAN MURARKA  DDS
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
11223G0001XGeneral Practice Dentistry27368TX
21223G0001XGeneral Practice Dentistry019.028851IL
31223G0001XGeneral Practice Dentistry12012075AIN

Other Identifiers

General Provider Information

NPI Number : 1689955304
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANISHA MOHAN MURARKA DDS
Provider Business Mailing Address
First Line : 520 S STATE ST APT 1013
Second Line :
City : CHICAGO
State : IL
Zip : 60605-1657
Country : US
Telephone Number : 832-265-6117
Fax Number :
Provider Business Practice Location Address
First Line : 4600 S PULASKI RD
Second Line :
City : CHICAGO
State : IL
Zip : 60632-4038
Country : US
Telephone Number : 773-376-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2011
Last Update Date : 01/29/2014

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Directions to “ DR. ANISHA MOHAN MURARKA DDS” Practice Location

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