Ravanam, Srinivas R
Ravanam, Srinivas R is an individual health care provider with primary practice located at 455 E Main St , East Dundee IL 60118-1529. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nuclear Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Ravanam, Srinivas R can be contacted via phone (847) 428-2273.Contact Information
Primary practice address
455 E Main St
East Dundee IL 60118-1529
Phone: (847) 428-2273
Fax: (847) 428-3128
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nuclear Medicine | 207U00000X | 036110141 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036110141 | Illinois |
| Allopathic & Osteopathic Physicians / Occupational Medicine | 2083X0100X | 036110141 | Illinois |
Profile Details
| NPI number | 1346294469 |
|---|---|
| LBN Legal business name | Ravanam, Srinivas R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 22nd, 2006 |
| Last updated | Feb 24th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346294469 | NPPES |
| Wisconsin | Other | 46940020 | STATE LICENSE |
| Wisconsin | MEDICAID | 036110141 | STATE LICENSE |
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