Healthcare Provider Details

I. General information

NPI: 1164983557
Provider Name (Legal Business Name): GAYATHRI DEVI VADLAMUDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N BARRINGTON RD
HOFFMAN ESTATES IL
60169-1019
US

IV. Provider business mailing address

1555 N BARRINGTON RD STE 505
HOFFMAN ESTATES IL
60169-1066
US

V. Phone/Fax

Practice location:
  • Phone: 847-490-6960
  • Fax:
Mailing address:
  • Phone: 847-490-6960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036177306
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberU2029
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number036177306
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: