Healthcare Provider Details

I. General information

NPI: 1700698263
Provider Name (Legal Business Name): MADHURIMA CHAUDHURI MBBS, MS, MRCSED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

1326 S MICHIGAN AVE APT 1606
CHICAGO IL
60605-3524
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5492
  • Fax:
Mailing address:
  • Phone: 773-573-4192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License Number125087643
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: