Ganapathi Gottumukkala

LBN: Ganapathi Gottumukkala
Ganapathi Gottumukkala is an health care organization with primary practice located at 6701 159Th St Suite B, Tinley Park IL 60477-1758. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Ganapathi Gottumukkala can be contacted via phone (708) 614-0893, or through Gottumukkala, Ganapathi via phone (708) 614-0893.

Contact Information

Primary practice address
6701 159Th St Suite B Tinley Park IL 60477-1758
Phone: (708) 614-0893
Fax: (708) 342-1481
Website:
Map and Directions
Authorized official contact:
Name: Gottumukkala, Ganapathi Doctor of Medicine (MD)
Phone: (708) 614-0893

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-074987 Illinois

Profile Details

NPI number 1962457614
LBN Legal business name Ganapathi Gottumukkala
DBA Doing business as
Authorized official Gottumukkala, Ganapathi Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2006
Last updated Nov 25th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962457614 NPPES
Illinois Other 01625532 BCBSIL GROUP #

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