Provider Demographics
NPI:1619168481
Name:S K TALLURI MDSC
Entity Type:Organization
Organization Name:S K TALLURI MDSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SRIKRISHNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:TALLURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-323-0024
Mailing Address - Street 1:2200 W HIGGINS RD STE 245
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2426
Mailing Address - Country:US
Mailing Address - Phone:630-323-0024
Mailing Address - Fax:630-323-6670
Practice Address - Street 1:2200 W HIGGINS RD STE 245
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2426
Practice Address - Country:US
Practice Address - Phone:630-323-0024
Practice Address - Fax:630-323-6670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty