Healthcare Provider Details

I. General information

NPI: 1831145416
Provider Name (Legal Business Name): SHEELA SWAMY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 WARREN AVE
DOWNERS GROVE IL
60515-3601
US

IV. Provider business mailing address

1121 WARREN AVE STE 200
DOWNERS GROVE IL
60515-3572
US

V. Phone/Fax

Practice location:
  • Phone: 630-969-9200
  • Fax: 630-969-9440
Mailing address:
  • Phone: 630-969-9200
  • Fax: 630-969-9440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036081176
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: