Basic Information
Provider Information
NPI: 1881942886
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ATLURI
FirstName: SREEDEVI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 676 N SAINT CLAIR ST
Address2: STE 1400
City: CHICAGO
State: IL
PostalCode: 606112927
CountryCode: US
TelephoneNumber: 3126955620
FaxNumber:  
Practice Location
Address1: 676 N SAINT CLAIR ST
Address2: STE 1400
City: CHICAGO
State: IL
PostalCode: 606112927
CountryCode: US
TelephoneNumber: 3126955620
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/22/2012
LastUpdateDate: 05/10/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000XQ8014TXN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X266056-1NYN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RG0100X336098118ILY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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