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MULLAPUDI MEDICAL LLC NPI 1811219017


NPI Information

NPI: 1811219017
Provider Name: MULLAPUDI MEDICAL LLC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 14D2085889

Address:
2S607 AVENUE VENDOME
OAK BROOK, IL
ZIP 60523
Phone: (630) 926-5409
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MULLAPUDI MEDICAL LLC is a general practice in Oak Brook, IL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MULLAPUDI MEDICAL LLC NPI is 1811219017. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2S607 AVENUE VENDOME
OAK BROOK, IL
ZIP 60523-073
Phone: (630) 926-5409

The provider's authorized official is Rajendra Mullapudi .
The authorized official title is President and has the following contact phone number (630) 926-5409.

The CLIA number assigned to this NPI record is 14D2085889 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/16/2010 and was last updated on 2/16/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral Practice036119143ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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