MEDICARE: DR. RAMI DOUKKY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036-096737	IL
2	207UN0901X	Nuclear Cardiology Physician	036-096737	IL
3	174400000X	Specialist	036-096737	IL
4	207RC0000X	Cardiovascular Disease Physician	036-096737	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093761181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAMI DOUKKY M.D.

Provider Business Mailing Address
First Line	:	1725 W HARRISON ST STE 1159
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3883
Country	:	US
Telephone Number	:	312-942-5020
Fax Number	:	312-942-4039

Provider Business Practice Location Address
First Line	:	1725 W HARRISON ST
Second Line	:	SUITE 1159
City	:	CHICAGO
State	:	IL
Zip	:	60612-3841
Country	:	US
Telephone Number	:	312-942-5020
Fax Number	:	312-942-4039

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	06/19/2026

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