Individual
RAJENDRA DAHAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
615 35TH AVE, MOLINE, IL 61265-6107
(309) 757-7780
(309) 757-7719
Mailing address
615 35TH AVE, MOLINE, IL 61265-6107
(309) 757-7780
(309) 757-7719
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
036088655
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136127
—
IA
05
—
0175471
—
IA
05
—
036088655
—
IL
05
—
0510917
—
IA
01
—
08100343
BLUE CROSS BLUE SHIELD
IL
05
—
1136127
—
IA
01
—
55645
WELLMARK
IA
01
—
56266
NORIDIAN
IA
01
—
90937
WELLMARK
IL
01
—
93122
WELLMARK GROUP
IL
Enumeration date
06/09/2005
Last updated
11/21/2019
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