Shyam M Puppala MDSC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036073281 Issued in IL

Legal business name

SHYAM M PUPPALA MDSC

Practice address

4755 N Kenmore Ave
Chicago, IL 60640-5015

Phone

(773) 989-9868

Fax

(773) 989-9824

NPI assigned

Apr 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Shyam Puppala, M.D.

Title

Ceo

Phone

(773) 989-9868

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1578737631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 RED HILL LN",
            "city": "SOUTH BARRINGTON",
            "state": "IL",
            "postal_code": "600106188",
            "telephone_number": "773-989-9868",
            "fax_number": "773-989-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 N KENMORE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405015",
            "telephone_number": "773-989-9868",
            "fax_number": "773-989-9824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHYAM M PUPPALA MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "PUPPALA",
        "authorized_official_first_name": "SHYAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-989-9868",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036073281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073281",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marina Shvartsman, M.D.
• Yuri Shvartsman, M.D.
• Vitaliy Shvets, D.D.S.
• Wendy Shwe, MD
• Sonia Shweiki, D.D.S.
• Shyam M Puppala MDSC
• Shyam Pharmacy
• Elana Shyman, BCBA
• Si Herman DPM LTD
• Gabriel Lok-Hymn Si, MD

• Psychiatry Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.