MEDICARE: RAJU GHATE MD

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	207X00000X	Orthopaedic Surgery Physician	036-106509	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184676371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJU GHATE MD

Provider Business Mailing Address
First Line	:	680 NORTH LAKE SHORE DRIVE
Second Line	:	ATTN: LILLI KORNBLUM SUITE 1028
City	:	CHICAGO
State	:	IL
Zip	:	60053-2116
Country	:	US
Telephone Number	:	312-475-5535
Fax Number	:

Provider Business Practice Location Address
First Line	:	680 N LAKE SHORE DR
Second Line	:	SUITE 1028
City	:	CHICAGO
State	:	IL
Zip	:	60611-4546
Country	:	US
Telephone Number	:	312-664-6848
Fax Number	:

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	02/11/2021

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