Provider Demographics
NPI:1386840148
Name:RAO, SHEETAL KHEDKAR (MD)
Entity Type:Individual
Prefix:
First Name:SHEETAL
Middle Name:KHEDKAR
Last Name:RAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEETAL
Other - Middle Name:PRAKASH
Other - Last Name:KHEDKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1801 W TAYLOR ST STE 3AA
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4795
Mailing Address - Country:US
Mailing Address - Phone:312-355-1700
Mailing Address - Fax:
Practice Address - Street 1:1801 W. TAYLOR ST.
Practice Address - Street 2:SUITE 3AA
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:123-551-7003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.125059207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine