MEDICARE: THODUR M RANGANATHAN 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	2084P0800X	Psychiatry Physician	036-081441	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	:	1841269727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THODUR M RANGANATHAN M.D.

Provider Business Mailing Address
First Line	:	13290 FOX HILL DR
Second Line	:
City	:	LEMONT
State	:	IL
Zip	:	60439-8194
Country	:	US
Telephone Number	:	630-257-0885
Fax Number	:	630-257-0875

Provider Business Practice Location Address
First Line	:	7531 S STONY ISLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-3954
Country	:	US
Telephone Number	:	773-947-7900
Fax Number	:	773-947-7901

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/27/2016

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