Provider Demographics
NPI:1104898907
Name:RAO, RAMESH (MD)
Entity type:Individual
Prefix:
First Name:RAMESH
Middle Name:
Last Name:RAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:967 MCLEAN AVE
Mailing Address - Street 2:SUITE 387
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-4107
Mailing Address - Country:US
Mailing Address - Phone:914-237-6797
Mailing Address - Fax:914-206-4950
Practice Address - Street 1:6840 W TOUHY AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-4520
Practice Address - Country:US
Practice Address - Phone:914-237-6797
Practice Address - Fax:914-206-4950
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360569772086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL4783002Medicare PIN
D150817Medicare UPIN
ILK20116Medicare PIN
ILP00287681Medicare PIN