IndividualActive
Bhadra Komarraju, APRN AGNP-C
NPI 1831529296 · Gerontology Nurse Practitioner · Hillside, IL
Provider details
- NPI number
- 1831529296
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- APRN AGNP-C
- Sex
- Male
- Sole proprietor
- No
- License
- 209010785 (IL)
Mailing address
Po Box 45
Madison, IL 62060-0045
Registry dates
- Enumerated
- 2013-11-22
- Last updated
- 2018-03-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.