Raju, Pradeep N

Raju, Pradeep N is an individual health care provider with primary practice located at 4119 W Shamrock Ln , Mchenry IL 60050-8268. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Raju, Pradeep N can be contacted via phone (815) 398-9491.

Contact Information

Primary practice address
4119 W Shamrock Ln Mchenry IL 60050-8268
Fax: (815) 381-7498
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 036140194 Illinois

Profile Details

NPI number 1568723211
LBN Legal business name Raju, Pradeep N
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2012
Last updated Aug 11th, 2023 - about 2 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568723211 NPPES
Illinois MEDICAID 036140194
Illinois MEDICAID 0114301

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