Ravipati, Mamata
Ravipati, Mamata is an sole proprietor health care provider with primary practice located at 3471 Green Bay Rd , North Chicago IL 60064-3090. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Ravipati, Mamata can be contacted via phone (847) 473-4357.Contact Information
Primary practice address
3471 Green Bay Rd
North Chicago IL 60064-3090
Phone: (847) 473-4357
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036-104010 | Illinois |
Profile Details
| NPI number | 1962490169 |
|---|---|
| LBN Legal business name | Ravipati, Mamata |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 11th, 2005 |
| Last updated | Sep 26th, 2016 - about 8 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 | 1962490169 | NPPES |
| Illinois | MEDICAID | 036-104010-2 |
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