Rao, Sujatha A.

Rao, Sujatha A. is an sole proprietor health care provider with primary practice located at 1390 Hope Drive Suite 1, Carbondale IL 62901-1031. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Other Service Providers / Specialist. Other Service Providers / Specialist is her primary health care specialty. Rao, Sujatha A. can be contacted via phone (618) 529-0120.

Contact Information

Primary practice address
1390 Hope Drive Suite 1 Carbondale IL 62901-1031
Phone: (618) 529-0120
Fax: (618) 457-2501
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207RH0000X 036111928 Illinois
Other Service Providers / Specialist 174400000X 201307515 Illinois

Profile Details

NPI number 1356420368
LBN Legal business name Rao, Sujatha A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2006
Last updated Mar 8th, 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 1356420368 NPPES
Illinois MEDICAID 036111928

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