Healthcare Provider Details

I. General information

NPI: 1760665509
Provider Name (Legal Business Name): HRTS HOSPITALIST, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2007
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2913 N COMMONWEALTH AVE
CHICAGO IL
60657-6211
US

IV. Provider business mailing address

2913 N COMMONWEALTH AVE
CHICAGO IL
60657-6211
US

V. Phone/Fax

Practice location:
  • Phone: 773-665-3000
  • Fax:
Mailing address:
  • Phone: 773-665-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: SHESH RAO
Title or Position: OWNER
Credential: M.D.
Phone: 773-665-3000