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NPI Code Detail

MEDICARE: IYENGAR GERIATRIC HOSPITALIST SC

MEDICARE: IYENGAR GERIATRIC HOSPITALIST SC
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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number : 1447845144
Entity Type Code : Organization
Provider Name (Legal Business Name) : IYENGAR GERIATRIC HOSPITALIST SC
Provider Business Mailing Address
First Line : 720 S WELLS ST APT 2512
Second Line :
City : CHICAGO
State : IL
Zip : 60607-4796
Country : US
Telephone Number : 773-697-3729
Fax Number :
Provider Business Practice Location Address
First Line : 2674 N HALSTED ST
Second Line :
City : CHICAGO
State : IL
Zip : 60614-2361
Country : US
Telephone Number : 773-697-3729
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RAJESH IYENGAR
Credential : MD
Telephone Number : 773-697-3729
Provider Enumeration Date : 03/04/2021
Last Update Date : 03/04/2021

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Directions to “IYENGAR GERIATRIC HOSPITALIST SC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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