Provider Demographics
NPI:1679937791
Name:KUNDURU, MEGHANA (MD)
Entity Type:Individual
Prefix:
First Name:MEGHANA
Middle Name:
Last Name:KUNDURU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 N ARLINGTON HEIGHTS RD STE C
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1573
Mailing Address - Country:US
Mailing Address - Phone:847-788-8300
Mailing Address - Fax:847-788-8306
Practice Address - Street 1:3335 N ARLINGTON HEIGHTS RD STE C
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1573
Practice Address - Country:US
Practice Address - Phone:847-788-8300
Practice Address - Fax:847-788-8306
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-06
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361504132080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty