Healthcare Provider Details
I. General information
NPI: 1124106141
Provider Name (Legal Business Name): RAM VELAMATI MD SC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2900 N LAKESHORE DRIVE
CHICAGO IL
60657
US
IV. Provider business mailing address
9410 COMPUBILL DRIVE
ORLAND PARK IL
60462
US
V. Phone/Fax
- Phone: 773-665-3000
- Fax: 773-665-6494
- Phone: 708-460-7444
- Fax: 708-460-8662
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAMAKRISHNA
VELAMATI
Title or Position: PRESIDENT
Credential: MD
Phone: 773-665-3000