Provider Demographics
NPI:1306063730
Name:RATNASINGAM, UMASHANKAR (OD)
Entity type:Individual
Prefix:DR
First Name:UMASHANKAR
Middle Name:
Last Name:RATNASINGAM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:UMA
Other - Middle Name:
Other - Last Name:RATNASINGAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:212 E CULLERTON ST
Mailing Address - Street 2:APT # 811
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4328
Mailing Address - Country:US
Mailing Address - Phone:312-371-3836
Mailing Address - Fax:
Practice Address - Street 1:7610 ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-2295
Practice Address - Country:US
Practice Address - Phone:708-366-9278
Practice Address - Fax:708-366-9148
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist