Thota, Madhuri

Thota, Madhuri is an individual health care provider with primary practice located at 14 Lake St , Oak Park IL 60302-2606. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Thota, Madhuri can be contacted via phone (708) 383-0113.

Contact Information

Primary practice address
14 Lake St Oak Park IL 60302-2606
Phone: (708) 383-0113
Fax: (708) 383-9911
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036106024 Illinois
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036-106024 Illinois

Profile Details

NPI number 1851425383
LBN Legal business name Thota, Madhuri
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2007
Last updated Jul 20th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851425383 NPPES
Illinois MEDICAID 036-106024

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