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NPI Code Detail

MEDICARE: RANI GANESAN M.D.

MEDICARE: RANI GANESAN 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
12080P0203XPediatric Critical Care Medicine Physician036-111493IL

General Provider Information

NPI Number : 1205096963
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANI GANESAN M.D.
Provider Business Mailing Address
First Line : 2650 RIDGE AVE STE 1223
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number : 847-982-3671
Fax Number :
Provider Business Practice Location Address
First Line : 801 S WASHINGTON ST
Second Line :
City : NAPERVILLE
State : IL
Zip : 60540-7430
Country : US
Telephone Number : 630-527-3234
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2008
Last Update Date : 04/17/2026

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