MEDICARE: MR. NATVERLAL B SURATI M.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
1	208000000X	Pediatrics Physician	036-069532	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

General Provider Information

NPI Number	:	1649206988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NATVERLAL B SURATI M.D.

Provider Business Mailing Address
First Line	:	1045 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3327
Country	:	US
Telephone Number	:	773-248-8644
Fax Number	:	773-248-8723

Provider Business Practice Location Address
First Line	:	1045 W BELMONT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3327
Country	:	US
Telephone Number	:	773-248-8644
Fax Number	:	773-248-8723

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

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	04/30/2015

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