Mamata Ravipati, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036-104010 Issued in IL

Practice address

3471 Green Bay Rd
North Chicago, IL 60064-3090

Phone

(847) 473-4357

NPI assigned

Oct 11, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474848000000",
    "number": "1962490169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3537 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740035",
            "telephone_number": "708-786-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3471 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643090",
            "telephone_number": "847-473-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVIPATI",
        "first_name": "MAMATA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2016-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-104010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-104010-2",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ana Ramos
• Sunny Rana, CRNA
• Allen Rasmussen, DMD, MS
• Brooke Renee Rassel
• Alpa Bhanu Raval, M.D.
• Morad Razik
• Susan Margaret Regan, MSW
• Afrah Rehman
• Leola Reid, RN
• Denise Pan Remo-Nunez

• Internal Medicine Physician in North Chicago, IL
• Providers in North Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.