MEDICARE: MS. RAJESWARI CHINTAPALLI MD

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	207L00000X	Anesthesiology Physician	R4B56	MO
2	207L00000X	Anesthesiology Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	687948	OTHER	IL	HEALTHLINK PROVIDER #

General Provider Information

NPI Number	:	1891790689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RAJESWARI CHINTAPALLI MD

Provider Business Mailing Address
First Line	:	2112 CLAIRMONT DR
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62221-7833
Country	:	US
Telephone Number	:	618-257-1563
Fax Number	:	618-257-1568

Provider Business Practice Location Address
First Line	:	3635 VISTA AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-2539
Country	:	US
Telephone Number	:	314-577-8750
Fax Number	:	314-268-5102

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	02/13/2008

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