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NPI Code Detail

MEDICARE: DR. VENKATA Y BEHARA MD

MEDICARE: DR. VENKATA Y BEHARA 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
1207RN0300XNephrology Physician036113921IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11616108OTHERILBCBS GROUP/NUMBER

General Provider Information

NPI Number : 1376728113
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VENKATA Y BEHARA MD
Provider Business Mailing Address
First Line : 120 W 22ND ST STE 200
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1563
Country : US
Telephone Number : 630-573-5000
Fax Number :
Provider Business Practice Location Address
First Line : 601 W GOLF RD
Second Line : SUITE 105
City : MOUNT PROSPECT
State : IL
Zip : 60056-4276
Country : US
Telephone Number : 847-298-0600
Fax Number : 847-298-6395
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2007
Last Update Date : 01/30/2023

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Directions to “ DR. VENKATA Y BEHARA MD” Practice Location

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