BAPUSHETTY MADOORI MD SC
Ambulatory Health at Wentworth Ave, Chicago, IL

License number
Illinois 036057250
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. BAPUSHETTY MADOORI M.D.
Title: PRESIDENT
Phone: (708) 590-9805
Address
Address 2
6905 S Wentworth Ave, Chicago, IL 60621
15617 Sunset Ridge Dr, Orland Park, IL 60462
National Provider ID: 1508018326
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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BAPUSHETTY MADOORI, M.D., S.C

Orland Park, IL 60462

Registration:
Sep 30, 1980
State ID:
52177944
Business type:
DOMESTIC BCA
Expiration:
PERPETUAL
Agent:
Bapushetty Madoori,15617 Sunset Rdg Dr, Orland Park, IL 60462 (Physical)

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