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General NPI Number Information
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NPI Number | 1669588489
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Entity Type | Individual
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Provider Name | CHANDRASEKHAR SOMPALLI MD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 1401 S HARLEM AVE
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City | BERWYN
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State | IL
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Zip | 60402-1259
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Country | US
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Telephone | 773-229-1414
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Fax | 773-904-9857
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Provider Business Mailing Address
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Address Line | 1401 S HARLEM AVE
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City | BERWYN
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State | IL
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Zip | 60402-1259
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Country | US
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Telephone | 773-229-1414
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Fax | 773-904-9857
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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 | 036094752
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License Number State | IL
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