MEDICARE: MYNA MEDICAL LTD

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	207R00000X	Internal Medicine Physician		IL

General Provider Information

NPI Number	:	1497924278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYNA MEDICAL LTD

Provider Business Mailing Address
First Line	:	PO BOX 388320
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60638-8320
Country	:	US
Telephone Number	:	773-767-8283
Fax Number	:	773-767-8320

Provider Business Practice Location Address
First Line	:	5958 W LAWRENCE AVE
Second Line	:	SUITE 102
City	:	CHICAGO
State	:	IL
Zip	:	60630-3130
Country	:	US
Telephone Number	:	773-283-3199
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAMALINGAPPA NAGARAJU
Credential	:	M..D.
Telephone Number	:	773-283-3199

Provider Enumeration Date	:	02/26/2008
Last Update Date	:	02/26/2008

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Directions to “MYNA MEDICAL LTD ” Practice Location

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