Polavarapu, Nagendra

Polavarapu, Nagendra is an individual health care provider with primary practice located at 4440 W 95Th St Ste 3192H , Oak Lawn IL 60453-2600. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Polavarapu, Nagendra can be contacted via phone (708) 684-5685.

Contact Information

Primary practice address
4440 W 95Th St Ste 3192H Oak Lawn IL 60453-2600
Phone: (708) 684-5685
Fax: (708) 684-4712
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 036119683 Illinois
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 38700 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036-119683 Illinois

Profile Details

NPI number 1881731255
LBN Legal business name Polavarapu, Nagendra
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2007
Last updated Feb 20th, 2023 - about last year

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 1881731255 NPPES
Illinois MEDICAID 036119683

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