Provider Demographics
NPI:1194912097
Name:SOUMYA HEALTH, LLC
Entity type:Organization
Organization Name:SOUMYA HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JYOTHI
Authorized Official - Middle Name:
Authorized Official - Last Name:YALLAPRAGADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-404-6633
Mailing Address - Street 1:6120 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5226
Mailing Address - Country:US
Mailing Address - Phone:630-323-8595
Mailing Address - Fax:630-735-5138
Practice Address - Street 1:621 PLAINFIELD RD
Practice Address - Street 2:SUITE 107
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-5343
Practice Address - Country:US
Practice Address - Phone:847-924-0299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-099711207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty