NPIMap

Organization Active NPI

Rao Uppuuluri, M.D.S.C.

  • Medical Physician Assistant
  • Homewood, IL
National Provider Identifier
1609259126
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085005481 Issued in IL
Legal business name
RAO UPPUULURI, M.D.S.C.
Practice address
17901 Governors Hwy
Suite 202
Homewood, IL 60430-1144
Phone
(708) 957-0221
Fax
(708) 957-4519
NPI assigned
Jul 1, 2015
Last updated
Jul 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Fran M Norris
Title
Office Manager
Phone
(708) 957-0021

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X 085005481 IL Primary

Addresses

Primary practice location

17901 Governors Hwy
Suite 202
Homewood, IL 60430-1144

Mailing address

17901 Governors Hwy
Suite 202
Homewood, IL 60430-1144
Phone (708) 957-0221

National Provider Directory

National Provider Directory

Locations

17901 Governors Hwy
Ste 202
Homewood, IL 60430
Phone (708) 957-0220

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435708800000",
    "number": "1609259126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17901 GOVERNORS HWY",
            "address_2": "SUITE 202",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301144",
            "telephone_number": "708-957-0221",
            "fax_number": "708-957-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17901 GOVERNORS HWY",
            "address_2": "SUITE 202",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604301144",
            "telephone_number": "708-957-0221",
            "fax_number": "708-957-4519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAO UPPUULURI, M.D.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "FRAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-957-0021",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085005481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.