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General NPI Number Information
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NPI Number | 1417229584
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Entity Type | Organization
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Legal Business Name | RAJPUT MEDICAL CLINIC LTD
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 309 N.W. 2ND ST.
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City | ALEDO
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State | IL
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Zip | 61231-1404
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Country | US
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Telephone | 309-582-7283
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Fax | 309-582-2667
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Provider Business Mailing Address
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Address Line | 309 N.W. 2ND ST.
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City | ALEDO
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State | IL
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Zip | 61231-1404
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Country | US
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Telephone | 309-582-7283
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Fax | 309-582-2667
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MOHAMED IL RAJPUT
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Credential | M.D.
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Telephone | 309-582-7283
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036053130
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 036053130
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License Number State | IL
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