Srinivas R Ravanam
Internist Nuclear Medicine Specialist
455 E Main St
East Dundee
, Illinois 60118-1529
Srinivas R Ravanam
Internist Nuclear Medicine Specialist
455 E Main St
East Dundee
, Illinois 60118-1529
(847) 428-3128
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About
Features
Specialties
- Internist
- Nuclear Medicine Specialist
Languages spoken
- English
Location
First Address
- Srinivas R Ravanam
- 455 E Main St
- East Dundee, IL
- Zip : 60118-1529
- Fax : (847) 428-3128
- Phone : (847) 428-2273
Second Address
- Srinivas R Ravanam
- 455 E Main St
- East Dundee, IL
- Zip : 60118-1529
- Fax : (847) 428-3128
- Phone : (847) 428-2273
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207R00000X | Internist | 036110141 | IL |
| Y | 111NI0900X | Internist | 036110141 | IL |
| N | 207U00000X | Nuclear Medicine Specialist | 036110141 | IL |
National Provider Identifier
| NPI | 1346294469 |
|---|---|
| Provider Name | Srinivas R Ravanam |
| First Address | East Dundee, IL 60118-1529 |
| Second Address | East Dundee, IL 60118-1529 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/05/2006 |
| Last Update Date | 24/02/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036110141 | (05) | IL |
| 46940020 | STATE LICENSE (01) | WI |
| I47280 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.