# RAO UPPUULURI, M.D.S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609259126
- **Authorized official:** MRS. FRAN M NORRIS (OFFICE MANAGER)
- **Authorized official phone:** (708) 957-0021

## Contact information

- **Practice address:** 17901 GOVERNORS HWY, SUITE 202, HOMEWOOD, IL 60430-1144
- **Practice address phone:** (708) 957-0221
- **Practice address fax:** (708) 957-4519
- **Mailing address:** 17901 GOVERNORS HWY, SUITE 202, HOMEWOOD, IL 60430-1144
- **Mailing address phone:** (708) 957-0221
- **Mailing address fax:** (708) 957-4519

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AM0700X | Medical Physician Assistant | 085005481 | IL | Yes |

## Other

- **Enumeration date:** 07/01/2015
- **Last updated:** 07/01/2015