MEDICARE: SRIYA MURALIDHARAN MD

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
1	207RG0100X	Gastroenterology Physician	036164730	IL

General Provider Information

NPI Number	:	1174085179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SRIYA MURALIDHARAN MD

Provider Business Mailing Address
First Line	:	2650 RIDGE AVE STE 1223
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-1700
Country	:	US
Telephone Number	:	847-570-2040
Fax Number	:	847-570-5315

Provider Business Practice Location Address
First Line	:	5140 N. CALIFORNIA AVE.
Second Line	:	DEPARTMENT OF GASTROENTEROLOGY
City	:	CHICAGO
State	:	IL
Zip	:	60625
Country	:	US
Telephone Number	:	773-907-3038
Fax Number	:	773-989-3815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	04/20/2026

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