Healthcare Provider Details

I. General information

NPI: 1730323403
Provider Name (Legal Business Name): RANI CHOVATIYA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST STE 3200W
CHICAGO IL
60612-7232
US

IV. Provider business mailing address

1740 W TAYLOR ST STE 3200W
CHICAGO IL
60612-7232
US

V. Phone/Fax

Practice location:
  • Phone: 312-996-4020
  • Fax: 312-996-4019
Mailing address:
  • Phone: 312-996-4020
  • Fax: 312-996-4019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number62661-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number62661-20
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036.128884
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: