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NPI Code Detail

MEDICARE: DR. RASA THARP O.D.

MEDICARE: DR. RASA THARP O.D.
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
1152W00000XOptometrist046010144IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508012485
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RASA THARP O.D.
Provider Business Mailing Address
First Line : KAYE LN
Second Line :
City : HINSDALE
State : IL
Zip : 60527-6019
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4700 135TH ST
Second Line :
City : CRESTWOOD
State : IL
Zip : 60418-1405
Country : US
Telephone Number : 708-489-6951
Fax Number : 708-489-8012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2008
Last Update Date : 01/07/2026

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