Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 036 046374 | IL |
NPI | 1073942264 |
---|---|
Provider Name | Dr. Padma Tipirneni |
First Address | Orland Park, IL 60467-8210 |
Second Address | Orland Park, IL 60467-8210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2013 |
Last Update Date | 07/11/2013 |