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General NPI Number Information
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NPI Number | 1174985055
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Entity Type | Individual
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Provider Name | ANITA RAO M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 446 E ONTARIO ST STE 7-200
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City | CHICAGO
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State | IL
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Zip | 60611-4418
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Country | US
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Telephone | 312-694-0284
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Fax | 508-934-7380
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Provider Business Mailing Address
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Address Line | 446 E ONTARIO ST STE 7-200
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City | CHICAGO
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State | IL
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Zip | 60611-4418
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Country | US
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Telephone | 312-694-0284
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Fax | 508-934-7380
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0361511263
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License Number State | IL
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