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General NPI Number Information
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NPI Number | 1881634707
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Entity Type | Individual
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Provider Name | RAJA R NADIMPALLI MD
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Gender | Female
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3000 N HALSTED ST 209
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City | CHICAGO
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State | IL
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Zip | 60657-5188
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Country | US
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Telephone | 773-296-3500
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Fax | 773-296-3539
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Provider Business Mailing Address
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Address Line | 1960 KEATS LN
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-1628
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Country | US
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Telephone | 847-831-5236
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | IL
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