Provider Demographics
NPI:1073695284
Name:RAKESH MARWAHA M.D. S.C.
Entity Type:Organization
Organization Name:RAKESH MARWAHA M.D. S.C.
Other - Org Name:NAPERVILLE INTERNIST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-527-6390
Mailing Address - Street 1:PO BOX 6010
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-7010
Mailing Address - Country:US
Mailing Address - Phone:630-527-6390
Mailing Address - Fax:630-527-6392
Practice Address - Street 1:1190 S NAPER BLVD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-8331
Practice Address - Country:US
Practice Address - Phone:630-527-6390
Practice Address - Fax:630-527-6392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL94712Medicare PIN
IL203376Medicare PIN