Avula, Surendra B

Avula, Surendra B is an individual health care provider with primary practice located at 4950 W 95Th St , Oak Lawn IL 60453-2504. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Avula, Surendra B can be contacted via phone (708) 576-8150.

Contact Information

Primary practice address
4950 W 95Th St Oak Lawn IL 60453-2504
Phone: (708) 576-8150
Fax: (708) 576-8831
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036-082117 Illinois

Profile Details

NPI number 1275526071
LBN Legal business name Avula, Surendra B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2005
Last updated Jan 3rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275526071 NPPES
Illinois MEDICAID 036082117
Illinois Other 21622931
Illinois Other 060053845
Illinois Other CI8250

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