Most Relevant Information
Provider Data
| NPI Number: | 1003805151 |
| Provider Name: | VITTAL VENKATA CHAPA MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | 036052159 |
Most Important Dates
| Enumeration Date: | 10/20/2005 |
| Last Updated: | 05/15/2012 |
Provider Practice Location
138 E DEAN ST
VIRDEN
IL
626901446
Practice Location Phone/Fax
| Phone: | 2179655481 |
| Fax: | 2179655640 |
Provider Mailing Location
138 E DEAN ST
VIRDEN
IL
626901446
Provider Mailing Phone/Fax
| Phone: | 2179655481 |
| Fax: | 2179655640 |
Suggested EMR
Internist EMR