Provider Demographics
NPI:1225083645
Name:GEETHA R CATTAMANCHI MD
Entity Type:Organization
Organization Name:GEETHA R CATTAMANCHI MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GEETHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:CATTAMANCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-460-2663
Mailing Address - Street 1:10759 WINTERSET DR
Mailing Address - Street 2:UNIT A2
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-1106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10759 WINTERSET DR
Practice Address - Street 2:UNIT A2
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-1106
Practice Address - Country:US
Practice Address - Phone:708-460-2663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001632293OtherBCBS