Provider Demographics
NPI:1376601468
Name:AYIRALA, HEMALATHA (M D)
Entity Type:Individual
Prefix:
First Name:HEMALATHA
Middle Name:
Last Name:AYIRALA
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 FORD LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-5245
Mailing Address - Country:US
Mailing Address - Phone:847-338-6775
Mailing Address - Fax:630-369-0175
Practice Address - Street 1:101 S BROADWAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-4276
Practice Address - Country:US
Practice Address - Phone:630-896-7900
Practice Address - Fax:630-801-9182
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine