Provider Demographics
NPI:1225109044
Name:GOPI, RAM K (MD)
Entity Type:Individual
Prefix:
First Name:RAM
Middle Name:K
Last Name:GOPI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:17901 GOVERNORS HWY
Mailing Address - Street 2:#207
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1144
Mailing Address - Country:US
Mailing Address - Phone:708-799-8787
Mailing Address - Fax:708-799-8870
Practice Address - Street 1:17901 GOVERNORS HWY
Practice Address - Street 2:#207
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1144
Practice Address - Country:US
Practice Address - Phone:708-799-8787
Practice Address - Fax:708-799-8870
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2014-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL3650291207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036050291Medicaid
IL036050291Medicaid
C42036Medicare UPIN