Medavaram, Meher Bala
Medavaram, Meher Bala is an individual health care provider with primary practice located at 686 W Boughton Rd , Bolingbrook IL 60440-1520. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Medavaram, Meher Bala can be contacted via phone (630) 378-1234.Contact Information
Primary practice address
686 W Boughton Rd
Bolingbrook IL 60440-1520
Phone: (630) 378-1234
Fax: (630) 378-1155
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036072434 | Illinois |
Profile Details
| NPI number | 1376621359 |
|---|---|
| LBN Legal business name | Medavaram, Meher Bala |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Jan 31st, 2014 - about 12 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 | 1376621359 | NPPES |
| Other | 09921620 | BCBS | |
| MEDICAID | 036072434 | BCBS |
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