MEDICARE: PARAMESWAREN VENUGOPAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0000X	Hematology (Internal Medicine) Physician	036088953	IL

General Provider Information

NPI Number	:	1093774465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARAMESWAREN VENUGOPAL M.D.

Provider Business Mailing Address
First Line	:	1725 W HARRISON ST
Second Line	:	SUITE 1010
City	:	CHICAGO
State	:	IL
Zip	:	60612-3841
Country	:	US
Telephone Number	:	312-942-5904
Fax Number	:

Provider Business Practice Location Address
First Line	:	1725 W HARRISON ST
Second Line	:	SUITE 1010
City	:	CHICAGO
State	:	IL
Zip	:	60612-3841
Country	:	US
Telephone Number	:	312-942-5904
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	04/14/2011

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