Koppula, Bhasker Rao

Koppula, Bhasker Rao is an individual health care provider with primary practice located at 4201 W Medical Center Dr , Mchenry IL 60050-8409. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Koppula, Bhasker Rao can be contacted via phone (815) 334-5566.

Contact Information

Primary practice address
4201 W Medical Center Dr Mchenry IL 60050-8409
Phone: (815) 334-5566
Fax: (815) 759-4008
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nuclear Medicine 207U00000X 7682213-1205 Utah
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 7682213-1205 Utah
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036166661 Illinois

Profile Details

NPI number 1417033267
LBN Legal business name Koppula, Bhasker Rao
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Nov 27th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1417033267 NPPES
Other 339350 INTERNAL ID-MOTOR VEHICLE ID
MEDICAID 8443277 INTERNAL ID-MOTOR VEHICLE ID

Popular Providers