Provider Demographics
NPI:1427037043
Name:NATESH, R K (MD, PC)
Entity type:Individual
Prefix:DR
First Name:R
Middle Name:K
Last Name:NATESH
Suffix:
Gender:M
Credentials:MD, PC
Other - Prefix:DR
Other - First Name:RAMANTHAPUR
Other - Middle Name:
Other - Last Name:NATESH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PC
Mailing Address - Street 1:1100 ESSINGTON RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-8425
Mailing Address - Country:US
Mailing Address - Phone:815-725-2600
Mailing Address - Fax:815-725-2601
Practice Address - Street 1:1100 ESSINGTON RD
Practice Address - Street 2:SUITE 6
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8425
Practice Address - Country:US
Practice Address - Phone:815-725-2600
Practice Address - Fax:815-725-2601
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036084014208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09921473OtherBCBS
ILP00165337OtherMEDICARE RAILROAD
IL036084014Medicaid
K13141Medicare PIN