Individual
DR. VEERA A RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
690 E TERRA COTTA AVE STE A, CRYSTAL LAKE, IL 60014
(815) 455-2452
(815) 455-2789
Mailing address
690 E TERRA COTTA AVE STE A, CRYSTAL LAKE, IL 60014-3605
(815) 455-2452
(815) 455-2789
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036101157
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036101157
IL
208M00000X
Hospitalist Physician
036101157
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036101157
STATE LICENSE
IL
05
—
036101157
—
IL
01
—
1634621
BCBS
IL
01
—
F400163005
MEDICARE PTAN
IL
Enumeration date
07/05/2005
Last updated
03/17/2021
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