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General NPI Number Information
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NPI Number | 1013879246
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Entity Type | Organization
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Legal Business Name | AMANA INTEGRATIVE MEDICINE LLC
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Dates
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Enumeration Date | 11/25/2025
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 101 BEVERLY DR
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City | CHESTERTON
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State | IN
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Zip | 46304-3470
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Country | US
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Telephone | 630-340-8286
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Fax |
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Provider Business Mailing Address
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Address Line | 101 BEVERLY DR
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City | CHESTERTON
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State | IN
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Zip | 46304-3470
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Country | US
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Telephone | 630-340-8286
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | REVATHY AMEERUDDIN
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Credential | MD
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Telephone | 630-340-8286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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