Modur, Rekha
Modur, Rekha is an individual health care provider with primary practice located at 1431 N Western Ave Ste 401 , Chicago IL 60622-7712. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Modur, Rekha can be contacted via phone (773) 269-5540.Contact Information
Primary practice address
1431 N Western Ave Ste 401
Chicago IL 60622-7712
Phone: (773) 269-5540
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 019026099 | Illinois |
Profile Details
| NPI number | 1396704284 |
|---|---|
| LBN Legal business name | Modur, Rekha |
| Credentials | DDS DENTISTRY |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 21st, 2006 |
| Last updated | Apr 19th, 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 | 1396704284 | NPPES |
| New Mexico | MEDICAID | 32088256 |
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