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General NPI Number Information
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NPI Number | 1568642106
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Entity Type | Organization
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Legal Business Name | SINHA S CHUNDURI M.DS.C
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 675 W NORTH AVE SUITE 511
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City | MELROSE PARK
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State | IL
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Zip | 60160
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Country | US
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Telephone | 708-343-2235
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Fax | 708-343-2250
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Provider Business Mailing Address
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Address Line | 675 W NORTH AVE SUITE 511
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City | MELROSE PARK
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State | IL
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Zip | 60160
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Country | US
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Telephone | 708-343-2235
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Fax | 708-343-2250
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SINHA S CHUNDURI
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Credential | M.D
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Telephone | 708-343-2235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036048105
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License Number State | IL
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