Individual
ANUPA RAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 SUPERIOR ST, SUITE 101, MELROSE PARK, IL 60160-4138
(708) 344-2161
Mailing address
1633 S MICHIGAN AVE, APARTMENT 208, VILLA PARK, IL 60181-4145
(630) 865-9940
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125057304
IL
208M00000X
Hospitalist Physician
Primary
125057304
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036132491
—
IL
01
—
125057304
TEMPORARY MEDICAL LICENCE
IL
01
—
F400111213
MEDICARE PTAN
IL
Enumeration date
01/12/2012
Last updated
03/15/2021
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