Provider Demographics
NPI:1588704381
Name:DEVARAPALLI, HEYER C (MD)
Entity type:Individual
Prefix:
First Name:HEYER
Middle Name:C
Last Name:DEVARAPALLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 S EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3144
Mailing Address - Country:US
Mailing Address - Phone:847-296-0336
Mailing Address - Fax:847-789-8548
Practice Address - Street 1:1015 S EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3144
Practice Address - Country:US
Practice Address - Phone:847-296-0336
Practice Address - Fax:847-789-8548
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036117190207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL'036117190Medicaid
IL1637966OtherBCBS OF IL
IL'036117190Medicaid
ILK52881Medicare PIN
ILK45518Medicare PIN