MEDICARE: HRISANTHI ZHUPA

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	246Z00000X	Other Specialist/Technologist

General Provider Information

NPI Number	:	1316462807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HRISANTHI ZHUPA

Provider Business Mailing Address
First Line	:	7253 W TOUHY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-4326
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7253 W TOUHY AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-4326
Country	:	US
Telephone Number	:	708-831-4978
Fax Number	:

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

Provider Enumeration Date	:	08/07/2017
Last Update Date	:	08/07/2017

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