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General NPI Number Information
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NPI Number | 1407387152
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Entity Type | Individual
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Provider Name | SWAPNA GUDIPATI M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 2222 W DIVISION ST STE 100
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City | CHICAGO
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State | IL
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Zip | 60622-3093
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Country | US
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Telephone | 773-326-2244
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Fax | 773-342-3344
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Provider Business Mailing Address
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Address Line | 2233 W DIVISION ST
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City | CHICAGO
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State | IL
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Zip | 60622-8151
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Country | US
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Telephone |
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Fax |
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301502289
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036171686
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 036171686
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License Number State | IL
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