Ganapathi Gottumukkala
Ganapathi Gottumukkala is a Family Medicine Physician in Tinley Park, Illinois. Licensed in Illinois. Registered with an NPI since 2006.
- Licensed in
- IL
- In the registry since
- 2006
Practice location Address checks out
6701 159th St Ste BTinley Park, IL 60477-1758
Phone: (708) 614-0893
Fax: (708) 342-1481
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Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence 036-074987 (IL) |
|---|
Record details
| NPI number | 1962457614 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Ganapathi Gottumukkala — Sole Proprietor · (708) 614-0893 |
| NPI enumerated | May 23, 2006 |
| Last updated in NPPES | November 25, 2009 |
| Mailing address | Po Box 849, Matteson, IL 60443-0849 |
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