Provider Demographics
NPI:1285879494
Name:NANNEGARI, VEENA (MD)
Entity type:Individual
Prefix:DR
First Name:VEENA
Middle Name:
Last Name:NANNEGARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 S WOOD ST
Mailing Address - Street 2:SUITE 1030
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4325
Mailing Address - Country:US
Mailing Address - Phone:312-996-7059
Mailing Address - Fax:312-996-5103
Practice Address - Street 1:840 S WOOD ST
Practice Address - Street 2:SUITE 1030
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4325
Practice Address - Country:US
Practice Address - Phone:312-996-7059
Practice Address - Fax:312-996-5103
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2015-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036133283207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program