Basic Information
| Provider Information | |||||||||
| NPI: | 1538325998 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUMRA | ||||||||
| FirstName: | RACHNA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 W HIGGINS RD | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | HOFFMAN ESTATES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601692428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8477813100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2200 W HIGGINS RD | ||||||||
| Address2: | SUITE 140 | ||||||||
| City: | HOFFMAN ESTATES | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601692428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8477813100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2008 | ||||||||
| LastUpdateDate: | 03/21/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 036126775 | IL | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 036126775 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | P01020346 | 01 | IL | RAILROAD MEDICARE PTAN | OTHER |