Provider Demographics
NPI:1851484679
Name:JAYASHREE R. RAJU, D.O., P.C.
Entity type:Organization
Organization Name:JAYASHREE R. RAJU, D.O., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAYASHREE
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAJU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-743-5099
Mailing Address - Street 1:8 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5311
Mailing Address - Country:US
Mailing Address - Phone:602-743-5099
Mailing Address - Fax:847-221-5900
Practice Address - Street 1:1585 N BARRINGTON RD STE 204
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5019
Practice Address - Country:US
Practice Address - Phone:847-221-2900
Practice Address - Fax:847-221-5900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036090272207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL860956590Other860956590