Provider Demographics
NPI:1154758985
Name:ENTOPY RESEARCH LLC
Entity type:Organization
Organization Name:ENTOPY RESEARCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRAVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNIYAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-498-2860
Mailing Address - Street 1:2525 S MICHIGAN AVE
Mailing Address - Street 2:SUITE 2-614
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2315
Mailing Address - Country:US
Mailing Address - Phone:312-498-2860
Mailing Address - Fax:
Practice Address - Street 1:2525 S MICHIGAN AVE
Practice Address - Street 2:SUITE 2-614
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2315
Practice Address - Country:US
Practice Address - Phone:312-498-2860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036105193207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1922040542Medicare NSC