Provider Demographics
NPI:1346406329
Name:RAO, POOJA JAMNADAS (MD)
Entity type:Individual
Prefix:
First Name:POOJA
Middle Name:JAMNADAS
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:POOJA
Other - Middle Name:BRIJ
Other - Last Name:JAMNADAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9005 W CERMAK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH RIVERSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60546-1017
Mailing Address - Country:US
Mailing Address - Phone:708-442-8010
Mailing Address - Fax:708-442-8009
Practice Address - Street 1:9005 W CERMAK RD
Practice Address - Street 2:
Practice Address - City:NORTH RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546-1017
Practice Address - Country:US
Practice Address - Phone:708-442-8010
Practice Address - Fax:708-442-8009
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036130357207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology