Provider Demographics
NPI:1215197785
Name:RAMPURWALA, MARIYA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIYA
Middle Name:
Last Name:RAMPURWALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIYA
Other - Middle Name:
Other - Last Name:SHAAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-9200
Mailing Address - Fax:
Practice Address - Street 1:745 FLETCHER DR STE 101-102
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4747
Practice Address - Country:US
Practice Address - Phone:847-742-0792
Practice Address - Fax:847-742-3585
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036129470208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILFS1356686OtherDEA