Active NPI
Jhansi Raju, MD
- Ophthalmology Physician
- Chicago, IL
National Provider Identifier
1013091032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 036-106018
- Practice address
- 3700 W 26TH St
Chicago, IL 60623-3824 - Phone
- (773) 542-5203
- Fax
- (773) 542-5841
- NPI assigned
- Oct 25, 2006
- Last updated
- May 14, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036-106018 | IL | Primary |
Addresses
Primary practice location
3700 W 26TH St
Chicago, IL 60623-3824
Mailing address
3700 W 26TH St
Chicago, IL 60623-3824
Phone (773) 542-5203
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-106018 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Jersey Refractive Professional Corporation | Ophthalmology | Past | Accepting new patients |
| Greenwich Eye Center | Ophthalmology | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Diamond Vision
- Ophthalmology Physician
- Paramus, NJ
- NPI 1336346618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336953600000",
"number": "1013091032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 W 26TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606233824",
"telephone_number": "773-542-5203",
"fax_number": "773-542-5841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 W 26TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606233824",
"telephone_number": "773-542-5203",
"fax_number": "773-542-5841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJU",
"first_name": "JHANSI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2012-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "IL",
"license": "036-106018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.