=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699797555
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAVITHA RAMAN MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2006
-----------------------------------------------------
Last Update Date | 12/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1400 W PARK ST
-----------------------------------------------------
City | URBANA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61801-2334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-337-2462
-----------------------------------------------------
Fax | 217-337-4541
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1100 TUSCOLA BLVD
-----------------------------------------------------
City | TUSCOLA
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 61953-2065
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 217-253-2020
-----------------------------------------------------
Fax | 217-253-2023
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 036099624
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------