| Doctor Name: | MR. GOPAL TERALANDUR RAGHUNATH |
| NPI Number: | 1073635777 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, MS, DPT, CSCS |
| License Number: | 070013042 |
| Business Practice Address: | 125 E Lake Cook Rd Suite 209 Buffalo Grove, IL - 600894356 |
| Business Phone Number: | 8475203382 |
| Business Fax Number: | 8475203404 |
| Mailing Address: | 125 E Lake Cook Rd, Ste. 209 BUFFALO GROVE |
| State: | IL |
| Postal Code: | 600894356 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/04/2007 |
| NPI Last Update Date: | 08/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 070013042 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |