Provider Demographics
NPI:1477971216
Name:TAMRAGOURI, KEERTHI (MD)
Entity Type:Individual
Prefix:MRS
First Name:KEERTHI
Middle Name:
Last Name:TAMRAGOURI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KEERTHI
Other - Middle Name:
Other - Last Name:RANGANATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:420 N SCHMIDT RD STE 230
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1737
Mailing Address - Country:US
Mailing Address - Phone:630-312-2000
Mailing Address - Fax:
Practice Address - Street 1:420 N SCHMIDT RD STE 230
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1737
Practice Address - Country:US
Practice Address - Phone:630-312-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-30
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-142907207R00000X
IL036142907207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine