Healthcare Provider Details

I. General information

NPI: 1619074176
Provider Name (Legal Business Name): RAMADEVI PARACHURI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RAMADEVI PARUCHURI M.D

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 07/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 S 5TH AVE EDWARD HINES VA HOSPITAL, SCI SERVICE ,BUILDING 128,
HINES IL
60141-3030
US

IV. Provider business mailing address

5 TH AND ROOSEVELT ROAD, EDWARD HINES JR VA HOSPITAL, SPINAL CORD SERVICE,BUILDING 128, ROOM -A 115
HINES IL
60141
US

V. Phone/Fax

Practice location:
  • Phone: 708-202-2241
  • Fax: 708-202-7960
Mailing address:
  • Phone: 708-202-2241
  • Fax: 708-202-7960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number336057811
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number336057811
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: