Search › Illinois › 207Q00000X
Moshini Sivasubramaniam
NPI 1720491467 · on the registry since 2014
Practice
- Address
- 5359 W Fullerton Ave
Chicago, IL 60639 - Phone
- (773) 836-7381
- Clinicians at this address
- 40
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 390200000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-01-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois