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General NPI Number Information
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NPI Number | 1629375589
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Entity Type | Organization
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Legal Business Name | SURESH V.SHINGALA MD LTD
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Dates
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Enumeration Date | 02/11/2011
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Last Update Date | 02/11/2011
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Provider Practice Location Address
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Address Line | 5015 N PAULINA ST 214
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City | CHICAGO
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State | IL
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Zip | 60640-2756
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Country | US
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Telephone | 773-784-8500
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Fax | 773-989-5412
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Provider Business Mailing Address
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Address Line | 5015 N PAULINA ST 214
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City | CHICAGO
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State | IL
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Zip | 60640-2756
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Country | US
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Telephone | 773-784-8500
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Fax | 773-989-5412
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SURESH V. SHINGALA
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Credential | M.D
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Telephone | 17737848500
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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 |
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License Number State |
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