Provider Demographics
NPI:1982448478
Name:KANAPAREDDY, RAJITA
Entity type:Individual
Prefix:
First Name:RAJITA
Middle Name:
Last Name:KANAPAREDDY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 ROYAL ST GEORGE
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-4527
Mailing Address - Country:US
Mailing Address - Phone:224-358-8460
Mailing Address - Fax:
Practice Address - Street 1:352 ROYAL ST GEORGE
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-4527
Practice Address - Country:US
Practice Address - Phone:224-358-8460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2025-04-16
Deactivation Date:2024-07-06
Deactivation Code:
Reactivation Date:2025-04-16
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program