Provider Demographics
NPI:1578711396
Name:NELLORE, RAMESH B
Entity Type:Individual
Prefix:MR
First Name:RAMESH
Middle Name:B
Last Name:NELLORE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 VANDERBILT CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2969
Mailing Address - Country:US
Mailing Address - Phone:630-527-1478
Mailing Address - Fax:
Practice Address - Street 1:2018 VANDERBILT CT
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-2969
Practice Address - Country:US
Practice Address - Phone:630-527-1478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL194.000500227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered