Basic Information
Provider Information
NPI: 1558926907
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAUNIYAR
FirstName: RAHUL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1500 S FAIRFIELD AVE
Address2:  
City: CHICAGO
State: IL
PostalCode: 606081782
CountryCode: US
TelephoneNumber: 7735422000
FaxNumber:  
Practice Location
Address1: 1500 S FAIRFIELD AVE
Address2:  
City: CHICAGO
State: IL
PostalCode: 606081782
CountryCode: US
TelephoneNumber: 7735422000
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/01/2019
LastUpdateDate: 08/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X036158800ILY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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