Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 036-113248 | IL |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 036113248 | IL |
NPI | 1003929126 |
---|---|
Provider Name | Ramkrishna G Mehendale |
First Address | Chicago, IL 60611-2292 |
Second Address | Chicago, IL 60611-2292 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 07/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I29255 | (02) | IL |