Sumalatha Khatroth
Family Medicine in Chicago, IL. Individual provider (NPI-1).
NPI number1457038366
StatusActive
Last updated in NPPESAug 2, 2023
Details
- NPI
- 1457038366
- Entity type
- Individual (NPI-1)
- Name
- Sumalatha Khatroth
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 3, 2023
- Certification date
- Aug 2, 2023
- Last updated
- Aug 2, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 125082998 | IL | Yes |
Practice location
7531 S Stony Island AveChicago, IL 60649-3954
Phone 920-930-1704
Mailing address
1625 E 75th StChicago, IL 60649-3603
Phone 773-947-7310
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