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NPI Code Detail

MEDICARE: VIDYA RAMANAVARAPU MD

MEDICARE: VIDYA RAMANAVARAPU 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
1207L00000XAnesthesiology Physician036133269IL
2207L00000XAnesthesiology Physician231705MA
3208VP0000XPain Medicine Physician036-133269IL

General Provider Information

NPI Number : 1477751055
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIDYA RAMANAVARAPU MD
Provider Business Mailing Address
First Line : 34121 EAGLE WAY
Second Line :
City : CHICAGO
State : IL
Zip : 60678-1341
Country : US
Telephone Number : 224-231-4363
Fax Number : 866-642-1525
Provider Business Practice Location Address
First Line : 1010 EXECUTIVE DR STE 250
Second Line :
City : WESTMONT
State : IL
Zip : 60559-6137
Country : US
Telephone Number : 630-920-2350
Fax Number : 630-323-5610
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2007
Last Update Date : 09/26/2022

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Directions to “ VIDYA RAMANAVARAPU MD” Practice Location

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