Provider Demographics
NPI:1740786680
Name:CHINTAM, LALITHASREE (MD)
Entity Type:Individual
Prefix:
First Name:LALITHASREE
Middle Name:
Last Name:CHINTAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 FOXFIELD RD STE 307
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-5799
Mailing Address - Country:US
Mailing Address - Phone:630-208-3200
Mailing Address - Fax:630-208-3201
Practice Address - Street 1:2900 FOXFIELD RD STE 307
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-5799
Practice Address - Country:US
Practice Address - Phone:630-208-3200
Practice Address - Fax:630-208-3201
Is Sole Proprietor?:No
Enumeration Date:2018-03-31
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036156928207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine