Healthcare Provider Details
I. General information
NPI: 1952544918
Provider Name (Legal Business Name): RATNESH KUMAR MBBS,MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/07/2009
Last Update Date: 02/07/2022
Certification Date: 02/07/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1585 BARRINGTON RD SUITE 601-A , DOCTOR'S BUILDING#2
HOFFMAN ESTATES IL
60169-1090
US
IV. Provider business mailing address
1S210 SUMMIT AVE
OAKBROOK TERRACE IL
60181-3933
US
V. Phone/Fax
- Phone: 847-884-5911
- Fax:
- Phone: 630-282-6002
- Fax: 630-282-7322
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 053520 |
| License Number State | CT |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 036.140474 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: