Basic Information
| Provider Information | |||||||||
| NPI: | 1609026467 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAKARLA | ||||||||
| FirstName: | RAJESH | ||||||||
| MiddleName: | KUMAR | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2400 N ROCKTON AVE | ||||||||
| Address2: | RADIOLOGY DEPARTMENT | ||||||||
| City: | ROCKFORD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 61101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157178478 | ||||||||
| FaxNumber: | 8157178794 | ||||||||
| Practice Location | |||||||||
| Address1: | 2400 N ROCKTON AVE | ||||||||
| Address2: | |||||||||
| City: | ROCKFORD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 611033655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8159712248 | ||||||||
| FaxNumber: | 8159683407 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 036121295 | IL | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.