Healthcare Provider Details

I. General information

NPI: 1720280019
Provider Name (Legal Business Name): DHANYA PURAM LIMAYE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DHANYA PURAM M.D.

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S CARLIN SPRINGS RD
ARLINGTON VA
22204-1044
US

IV. Provider business mailing address

5007 WASHINGTON ST
DOWNERS GROVE IL
60515-3749
US

V. Phone/Fax

Practice location:
  • Phone: 703-271-8800
  • Fax: 703-271-8585
Mailing address:
  • Phone: 703-477-8797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36116235
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101244554
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036116235
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: