Individual
GEORGINA SRINIVAS RAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1024 W MAIN ST, ST CHARLES, IL 60174-1745
(630) 262-2640
(630) 262-2645
Mailing address
1024 W MAIN ST, ST CHARLES, IL 60174-1745
(630) 262-2640
(630) 262-2645
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036098889
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4532713
BCBS
IL
Enumeration date
02/22/2007
Last updated
04/20/2022
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