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General NPI Number Information
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NPI Number | 1093918203
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Entity Type | Individual
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Provider Name | VENKAT SESHADRI MD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 12/20/2021
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Provider Practice Location Address
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Address Line | 19801 GOVERNORS HWY STE 160
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City | FLOSSMOOR
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State | IL
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Zip | 60422-4363
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Country | US
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Telephone | 708-957-0505
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Fax | 708-957-0506
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Provider Business Mailing Address
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Address Line | 19801 GOVERNORS HWY STE 160
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City | FLOSSMOOR
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State | IL
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Zip | 60422-4363
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Country | US
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Telephone | 708-957-0505
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Fax | 708-957-0506
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 036133341
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License Number State | IL
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