Rajasekhar Kolla, MD
Family Medicine in New Lenox, IL. Individual provider (NPI-1).
NPI number1720160179
StatusActive
Last updated in NPPESMar 7, 2022
Details
- NPI
- 1720160179
- Entity type
- Individual (NPI-1)
- Name
- Mr. Rajasekhar Kolla
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 19, 2006
- Certification date
- Mar 7, 2022
- Last updated
- Mar 7, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | C169363 | CA | Yes |
| 207Q00000X | Family Medicine | 036115460 | IL |
Practice location
100 Batson Ct Ste 204New Lenox, IL 60451-1571
Phone 815-462-1200
Mailing address
1800 Harrison St, 7th FlOakland, CA 94612-3429
Phone 510-625-2856 · Fax 877-738-4262
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