PUSHPA K MAMTANI

OTTAWA, IL
NPI1376527168
Former NamePUSHPA G BALASUBRAMANIAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: MI  4301503653)
Additional Taxonomies208000000X Pediatrics
(Licence: IL  36 064091)
Enumeration Date2005-12-05
Last Update Date2023-01-25
Business Address
PUSHPA K MAMTANI MD
1614 E NORRIS DR
OTTAWA, IL 61350-3681
Phone number: 815-433-1010
Mailing Address
PUSHPA K MAMTANI MD
1614 E NORRIS DR
OTTAWA, IL 61350-3681
Phone number: