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NPI Code Detail

MEDICARE: PRERANA RAO PA-C

MEDICARE: PRERANA RAO PA-C
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
1363A00000XPhysician AssistantIL

General Provider Information

NPI Number : 1376493858
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRERANA RAO PA-C
Provider Business Mailing Address
First Line : 1620 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3801
Country : US
Telephone Number : 312-942-6631
Fax Number :
Provider Business Practice Location Address
First Line : 1620 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3801
Country : US
Telephone Number : 312-942-6631
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ PRERANA RAO PA-C” Practice Location

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