Provider Demographics
NPI:1285864074
Name:VENKATARAMAN, ASHOK (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:
Last Name:VENKATARAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VENKATARAMAN
Other - Middle Name:
Other - Last Name:ASHOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:DEPARTMENT OF CARDIOVASCULAR AND THORACIC SURGERY
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-216-3145
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:DEPT OF SURGERY
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-966-1072
Practice Address - Fax:919-966-7841
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.137889208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)