Doctor Name: | MR. C.R. MOHAN C.R. RAO |
NPI Number: | 1578586020 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036042832 |
Business Practice Address: | 1802 W. Chicago Ave. Suite 2 Chicago, IL - 606225512 |
Business Phone Number: | 7732782998 |
Business Fax Number: | 7732782997 |
Mailing Address: | 1802 W. Chicago Ave., Suite 2 CHICAGO |
State: | IL |
Postal Code: | 606225512 |
Phone Number: | 7732782998 |
Fax Number: | 7732782997 |
NPI Enumeration Date: | 07/25/2006 |
NPI Last Update Date: | 12/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 036042832 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |