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:
Health care specialties
| Specialty | Code | License # | 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 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881731255 | NPPES |
| Illinois | MEDICAID | 036119683 |
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