Puppala, Shyam
Puppala, Shyam is an sole proprietor health care provider with primary practice located at 4755 N Kenmore Ave , Chicago IL 60640-5015. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Puppala, Shyam can be contacted via phone (773) 989-9868.Contact Information
Primary practice address
4755 N Kenmore Ave
Chicago IL 60640-5015
Phone: (773) 989-9868
Fax: (773) 989-9824
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 036073281 | Illinois |
Profile Details
| NPI number | 1043390099 |
|---|---|
| LBN Legal business name | Puppala, Shyam |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 16th, 2006 |
| Last updated | May 27th, 2008 - about 17 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 | 1043390099 | NPPES |
| Illinois | MEDICAID | 036073281 |
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