Provider Demographics
NPI:1073539680
Name:MCKENNA, RAJALAXMI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJALAXMI
Middle Name:
Last Name:MCKENNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10458 S PULASKI RD
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-4933
Mailing Address - Country:US
Mailing Address - Phone:708-636-1818
Mailing Address - Fax:708-636-2151
Practice Address - Street 1:10458 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-4933
Practice Address - Country:US
Practice Address - Phone:708-636-1818
Practice Address - Fax:708-636-2151
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036046355207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0031601474OtherBLUE SHIELD
IL036046355Medicaid
IL211195OtherMEDICARE
830004492OtherRAILROAD MEDICARE
IL211195OtherMEDICARE
IL036046355Medicaid