MEDICARE: BAPU PREMCHAND AREKAPUDI M.D.

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
1	207RP1001X	Pulmonary Disease Physician		IL

General Provider Information

NPI Number	:	1811985401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAPU PREMCHAND AREKAPUDI M.D.

Provider Business Mailing Address
First Line	:	2734 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1321
Country	:	US
Telephone Number	:	773-525-7720
Fax Number	:	773-525-9199

Provider Business Practice Location Address
First Line	:	2734 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1321
Country	:	US
Telephone Number	:	773-525-7720
Fax Number	:	773-525-9199

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2005
Last Update Date	:	07/09/2007

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