Individual
MR. RAJAGOPALA SWAMINATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3024 E EMPIRE ST STE EANDF, BLOOMINGTON, IL 61704-5402
(309) 451-3376
(309) 452-3376
Mailing address
3024 E EMPIRE ST STE E, BLOOMINGTON, IL 61704-5402
(309) 451-3376
(309) 452-3376
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036052561
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004006893
AETNA
—
01
—
036052561001
OSF HEALTHPLANS INC
—
01
—
070002088
RAILROAD MEDICARE
—
01
—
3712273010002
CIGNA HEALTHCARE
—
01
—
37122730101
JOHN DEERE HEALTH CARE
—
01
—
563285
HEALTHLINK
IL
01
—
7200602
BLUE CROSS BLUE SHIELD IL
IL
01
—
C619811
UNITED AMER INSURANCE CO
—
Enumeration date
06/08/2006
Last updated
06/11/2019
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