Kesava Krishna Bhogaraju, M.D.
Individual provider Active NPI Family Medicine Physician · Inverness, IL
NPI 1154529618 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1154529618
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Practice address
- 900 Middleton LN
Inverness, IL 60010-6136 - Phone
- (847) 946-6169
- Fax
- (847) 428-5231
- NPI assigned
- Jul 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036046477 | IL | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | IL | Yes |
Addresses
Primary practice location
900 Middleton LN
Inverness, IL 60010-6136
Mailing address
900 Middleton LN
Inverness, IL 60010-6136
Phone (847) 946-6169
Other names
- Dr. Kesava Krishna Bhogaraju
Other providers in Inverness, IL
- Aysha Azimuddin
- Falilat Olajumoke Bakare
- Joseph Vincent Baldassano
- Barrington Plastic Surgery, LTD
- Rebecca Benson
- Jennifer Bochat
- Valerie A Bond
- Susan Jean Brach
- Bravo Care of Inverness Inc
- Brennan Counseling, P.C.
All providers in Inverness, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.