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NPI Code Detail

MEDICARE: SUDHAKAR R. YETURU M.D.

MEDICARE: SUDHAKAR R. YETURU M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036-085168IL

General Provider Information

NPI Number : 1093828212
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUDHAKAR R. YETURU M.D.
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number : 708-636-7193
Provider Business Practice Location Address
First Line : 1357 W 103RD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60643-2392
Country : US
Telephone Number : 773-238-0800
Fax Number : 773-881-7239
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 12/20/2022

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