Individual provider Active NPI

Varun Shravah

  • Student in an Organized Health Care Education/Training Program
  • Forest Park, IL
National Provider Identifier
1619811205
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
310 Lathrop Ave Apt 102
Forest Park, IL 60130-1457
Phone
(310) 418-5267
NPI assigned
Apr 15, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

310 Lathrop Ave Apt 102
Forest Park, IL 60130-1457

Mailing address

310 Lathrop Ave Apt 102
Forest Park, IL 60130-1457
Phone (310) 418-5267

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1776211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1619811205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 LATHROP AVE APT 102",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301457",
            "telephone_number": "310-418-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 LATHROP AVE APT 102",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301457",
            "telephone_number": "310-418-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRAVAH",
        "first_name": "VARUN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-04-15",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.