Provider Demographics
NPI:1215405758
Name:AVD MEDICAL SC
Entity Type:Organization
Organization Name:AVD MEDICAL SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANIL VAMSI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOPPALAPUDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-964-7006
Mailing Address - Street 1:PO BOX 9237
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60567-0237
Mailing Address - Country:US
Mailing Address - Phone:630-964-7006
Mailing Address - Fax:630-964-7082
Practice Address - Street 1:3825 HIGHLAND AVE STE 3D
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1549
Practice Address - Country:US
Practice Address - Phone:630-964-7006
Practice Address - Fax:630-964-7082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty