Individual
MRS. LATHA RAVI
Active
Individual
MRS. LATHA RAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036-072768
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008200539
BCBS OF IL
IL
01
—
250002252
RAILROAD MEDICARE PIN
IL
01
—
33725
GROUP HEALTH PLAN
—
Enumeration date
07/29/2006
Last updated
05/22/2008
Update your record
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