Provider Demographics
NPI:1538325998
Name:BUMRA, RACHNA (DO)
Entity Type:Individual
Prefix:DR
First Name:RACHNA
Middle Name:
Last Name:BUMRA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 W HIGGINS RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2428
Mailing Address - Country:US
Mailing Address - Phone:847-781-3100
Mailing Address - Fax:
Practice Address - Street 1:2200 W HIGGINS RD
Practice Address - Street 2:SUITE 140
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2428
Practice Address - Country:US
Practice Address - Phone:847-781-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036126775208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01020346OtherRAILROAD MEDICARE PTAN
IL215188005Medicare PIN
ILIL2857004Medicare PIN