Provider Demographics
NPI:1518160720
Name:KOTHARI, RAJUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJUL
Middle Name:
Last Name:KOTHARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 N EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1716
Mailing Address - Country:US
Mailing Address - Phone:312-375-0638
Mailing Address - Fax:
Practice Address - Street 1:7411 LAKE ST STE 1120
Practice Address - Street 2:
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1882
Practice Address - Country:US
Practice Address - Phone:708-375-2505
Practice Address - Fax:708-869-4202
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.008666207V00000X
IN01082843A207VX0201X
IL36128285207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology