Individual
DR. SUBBIAH RAJAGURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 N MELVIN ST, GIBSON CITY, IL 60936-1477
(217) 784-2273
Mailing address
1120 N MELVIN ST, GIBSON CITY, IL 60936-1477
(217) 784-4251
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036-089144
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089144 1
—
IL
01
—
110120109
RAILROAD MEDICARE
—
01
—
279500
MEDICARE GROUP
—
Enumeration date
08/03/2006
Last updated
02/17/2026
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