MEDICARE: HEYER C DEVARAPALLI 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
1	207R00000X	Internal Medicine Physician	036117190	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1637966	OTHER	IL	BCBS OF IL

General Provider Information

NPI Number	:	1588704381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEYER C DEVARAPALLI MD

Provider Business Mailing Address
First Line	:	1015 S EVERGREEN AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-3144
Country	:	US
Telephone Number	:	847-296-0336
Fax Number	:	847-789-8548

Provider Business Practice Location Address
First Line	:	1015 S EVERGREEN AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-3144
Country	:	US
Telephone Number	:	847-296-0336
Fax Number	:	847-789-8548

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	08/17/2023

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