Madhu Gundavaram MD SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036112955 Issued in IL

Legal business name

MADHU GUNDAVARAM MD SC

Practice address

326 W 64TH St
Chicago, IL 60621-3114

Phone

(773) 962-3900

NPI assigned

Feb 2, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Madhu S Gundavaram, MD

Title

President

Phone

(773) 354-0210

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265068800000",
    "number": "1144552126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W HOBBIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102433",
            "telephone_number": "773-354-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-962-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADHU GUNDAVARAM MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-02",
        "last_updated": "2010-02-02",
        "status": "A",
        "authorized_official_last_name": "GUNDAVARAM",
        "authorized_official_first_name": "MADHU",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-354-0210",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036112955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112955",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Madero Diaz
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• Sima M Madhiwala, PHARM.D., BCPS
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• Sally Madiba-Carlson, MD
• Melanie Lynn Madigan, LCSW
• Komal Usha Chowdary Madineni, MD
• Madison Counseling Solutions LLC

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.