Active NPI
Dr Raj LTD
- Adult Mental Health Clinic/Center
- Chicago, IL
National Provider Identifier
1992968564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Mental Health Clinic/Center
- Legal business name
- DR RAJ LTD
- Practice address
- 4403 W Lawrence Ave
Suite: 200
Chicago, IL 60630-2513 - Phone
- (773) 736-1555
- Fax
- (773) 736-1552
- NPI assigned
- Jul 3, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Rajendra P Mullapudi, M.D.
- Title
- C.E.O.
- Phone
- (773) 736-1555
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | Primary |
Addresses
Primary practice location
4403 W Lawrence Ave
Suite: 200
Chicago, IL 60630-2513
Mailing address
4403 W Lawrence Ave
Suite: 200
Chicago, IL 60630-2513
Phone (773) 736-1555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036119143 | Medicaid | IL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Chicago, IL
- NPI 1679764096
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215043200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1221523200000",
"number": "1992968564",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4403 W LAWRENCE AVE",
"address_2": "SUITE: 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606302513",
"telephone_number": "773-736-1555",
"fax_number": "773-736-1552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4403 W LAWRENCE AVE",
"address_2": "SUITE: 200",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606302513",
"telephone_number": "773-736-1555",
"fax_number": "773-736-1552"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR RAJ LTD",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-03",
"last_updated": "2008-09-16",
"status": "A",
"authorized_official_last_name": "MULLAPUDI",
"authorized_official_first_name": "RAJENDRA",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "C.E.O.",
"authorized_official_telephone_number": "773-736-1555",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036119143",
"state": "IL"
}
],
"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 Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.