MEDICARE: DR. MALATHI RAO D.O.

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	2084V0102X	Vascular Neurology Physician	036136041	IL
2	2084N0400X	Neurology Physician	036136041	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	206147	OTHER	IL	MEDICARE PTAN (GROUP)
3	F400166053	OTHER	IL	MEDICARE PTAN (INDIVIDUAL)

Other Identifiers

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

General Provider Information

NPI Number	:	1265694525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MALATHI RAO D.O.

Provider Business Mailing Address
First Line	:	25 N WINFIELD RD
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1295
Country	:	US
Telephone Number	:	630-933-4056
Fax Number	:	630-933-4057

Provider Business Practice Location Address
First Line	:	1411 S MICHIGAN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-2810
Country	:	US
Telephone Number	:	312-942-4500
Fax Number	:

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

Provider Enumeration Date	:	06/27/2008
Last Update Date	:	01/09/2026

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Directions to “ DR. MALATHI RAO D.O.” Practice Location

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