Healthcare Provider Details

I. General information

NPI: 1275112658
Provider Name (Legal Business Name): MEGHANA BABU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 S HIGHLAND AVE STE 220
LOMBARD IL
60148-4932
US

IV. Provider business mailing address

PO BOX 713260
CHICAGO IL
60677-1260
US

V. Phone/Fax

Practice location:
  • Phone: 630-873-8700
  • Fax: 630-873-8702
Mailing address:
  • Phone: 630-469-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number036-180366
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: