Provider Demographics
NPI:1245557297
Name:SURKAR, RAJESH P (OT)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:P
Last Name:SURKAR
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 N PLUM GROVE RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4775
Mailing Address - Country:US
Mailing Address - Phone:847-517-1900
Mailing Address - Fax:
Practice Address - Street 1:939 N PLUM GROVE RD
Practice Address - Street 2:SUITE G
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4775
Practice Address - Country:US
Practice Address - Phone:847-517-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.005168225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL3816003Medicare PIN
ILIL1673004Medicare PIN
IL212550002Medicare PIN