Provider Demographics
NPI:1306068200
Name:NATARAJAN, JANAKI (MD)
Entity type:Individual
Prefix:
First Name:JANAKI
Middle Name:
Last Name:NATARAJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2357 SEQUOIA DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-6222
Mailing Address - Country:US
Mailing Address - Phone:630-859-6800
Mailing Address - Fax:
Practice Address - Street 1:1221 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1404
Practice Address - Country:US
Practice Address - Phone:630-859-8700
Practice Address - Fax:630-264-8496
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST010972081H0002X
IL036-1245002081P2900X, 2081H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081H0002XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036124500Medicaid
IL036-124500OtherIL MEDICAL LICENSE
IA1306068200Medicaid
NE47037660425Medicaid
KST01097OtherTEMP MEDICAL LICENSE
NE24284OtherNE MEDICAL LICENSE
IL036124500Medicaid
KST01097OtherTEMP MEDICAL LICENSE
IL0727500002Medicare NSC
IL214229007Medicare PIN